Daily Papers

Multimodal Large Language Models (MLLMs) have exhibited immense potential across numerous medical specialties; yet, dentistry remains underexplored, in part due to limited domain-specific data, scarce dental expert annotations, insufficient modality-specific modeling, and challenges in reliability. In this paper, we present OralGPT-Omni, the first dental-specialized MLLM designed for comprehensive and trustworthy analysis across diverse dental imaging modalities and clinical tasks. To explicitly capture dentists' diagnostic reasoning, we construct TRACE-CoT, a clinically grounded chain-of-thought dataset that mirrors dental radiologists' decision-making processes. This reasoning supervision, combined with our proposed four-stage training paradigm, substantially strengthens the model's capacity for dental image understanding and analysis. In parallel, we introduce MMOral-Uni, the first unified multimodal benchmark for dental image analysis. It comprises 2,809 open-ended question-answer pairs spanning five modalities and five tasks, offering a comprehensive evaluation suite to date for MLLMs in digital dentistry. OralGPT-Omni achieves an overall score of 51.84 on the MMOral-Uni benchmark and 45.31 on the MMOral-OPG benchmark, dramatically outperforming the scores of GPT-5. Our work promotes intelligent dentistry and paves the way for future advances in dental image analysis. All code, benchmark, and models will be made publicly available.

Reliable interpretation of multimodal data in dentistry is essential for automated oral healthcare, yet current multimodal large language models (MLLMs) struggle to capture fine-grained dental visual details and lack sufficient reasoning ability for precise diagnosis. To address these limitations, we present DentalGPT, a specialized dental MLLM developed through high-quality domain knowledge injection and reinforcement learning. Specifically, the largest annotated multimodal dataset for dentistry to date was constructed by aggregating over 120k dental images paired with detailed descriptions that highlight diagnostically relevant visual features, making it the multimodal dataset with the most extensive collection of dental images to date. Training on this dataset significantly enhances the MLLM's visual understanding of dental conditions, while the subsequent reinforcement learning stage further strengthens its capability for multimodal complex reasoning. Comprehensive evaluations on intraoral and panoramic benchmarks, along with dental subsets of medical VQA benchmarks, show that DentalGPT achieves superior performance in disease classification and dental VQA tasks, outperforming many state-of-the-art MLLMs despite having only 7B parameters. These results demonstrate that high-quality dental data combined with staged adaptation provides an effective pathway for building capable and domain-specialized dental MLLMs.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Recent advances in large vision-language models (LVLMs) have demonstrated strong performance on general-purpose medical tasks. However, their effectiveness in specialized domains such as dentistry remains underexplored. In particular, panoramic X-rays, a widely used imaging modality in oral radiology, pose interpretative challenges due to dense anatomical structures and subtle pathological cues, which are not captured by existing medical benchmarks or instruction datasets. To this end, we introduce MMOral, the first large-scale multimodal instruction dataset and benchmark tailored for panoramic X-ray interpretation. MMOral consists of 20,563 annotated images paired with 1.3 million instruction-following instances across diverse task types, including attribute extraction, report generation, visual question answering, and image-grounded dialogue. In addition, we present MMOral-Bench, a comprehensive evaluation suite covering five key diagnostic dimensions in dentistry. We evaluate 64 LVLMs on MMOral-Bench and find that even the best-performing model, i.e., GPT-4o, only achieves 41.45% accuracy, revealing significant limitations of current models in this domain. To promote the progress of this specific domain, we also propose OralGPT, which conducts supervised fine-tuning (SFT) upon Qwen2.5-VL-7B with our meticulously curated MMOral instruction dataset. Remarkably, a single epoch of SFT yields substantial performance enhancements for LVLMs, e.g., OralGPT demonstrates a 24.73% improvement. Both MMOral and OralGPT hold significant potential as a critical foundation for intelligent dentistry and enable more clinically impactful multimodal AI systems in the dental field. The dataset, model, benchmark, and evaluation suite are available at https://github.com/isbrycee/OralGPT.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

Multimodal Large Language Models (MLLMs) inherit the superior text understanding capabilities of LLMs and extend these capabilities to multimodal scenarios. These models achieve excellent results in the general domain of multimodal tasks. However, in the medical domain, the substantial training costs and the requirement for extensive medical data pose challenges to the development of medical MLLMs. Furthermore, due to the free-text form of answers, tasks such as visual grounding that need to produce output in a prescribed form become difficult for MLLMs. So far, there have been no medical MLLMs works in medical visual grounding area. For the medical vision grounding task, which involves identifying locations in medical images based on short text descriptions, we propose Parameter-efficient Fine-tuning medical multimodal large language models for Medcial Visual Grounding (PFMVG). To validate the performance of the model, we evaluate it on a public benchmark dataset for medical visual grounding, where it achieves competitive results, and significantly outperforming GPT-4v. Our code will be open sourced after peer review.

In recent years, Multimodal Large Language Models (MLLM) have achieved notable advancements, demonstrating the feasibility of developing an intelligent biomedical assistant. However, current biomedical MLLMs predominantly focus on image-level understanding and restrict interactions to textual commands, thus limiting their capability boundaries and the flexibility of usage. In this paper, we introduce a novel end-to-end multimodal large language model for the biomedical domain, named MedPLIB, which possesses pixel-level understanding. Excitingly, it supports visual question answering (VQA), arbitrary pixel-level prompts (points, bounding boxes, and free-form shapes), and pixel-level grounding. We propose a novel Mixture-of-Experts (MoE) multi-stage training strategy, which divides MoE into separate training phases for a visual-language expert model and a pixel-grounding expert model, followed by fine-tuning using MoE. This strategy effectively coordinates multitask learning while maintaining the computational cost at inference equivalent to that of a single expert model. To advance the research of biomedical MLLMs, we introduce the Medical Complex Vision Question Answering Dataset (MeCoVQA), which comprises an array of 8 modalities for complex medical imaging question answering and image region understanding. Experimental results indicate that MedPLIB has achieved state-of-the-art outcomes across multiple medical visual language tasks. More importantly, in zero-shot evaluations for the pixel grounding task, MedPLIB leads the best small and large models by margins of 19.7 and 15.6 respectively on the mDice metric. The codes, data, and model checkpoints will be made publicly available at https://github.com/ShawnHuang497/MedPLIB.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

Multimodal large language models (MLLMs) have shown remarkable potential in various domains, yet their application in the medical field is hindered by several challenges. General-purpose MLLMs often lack the specialized knowledge required for medical tasks, leading to uncertain or hallucinatory responses. Knowledge distillation from advanced models struggles to capture domain-specific expertise in radiology and pharmacology. Additionally, the computational cost of continual pretraining with large-scale medical data poses significant efficiency challenges. To address these issues, we propose InfiMed-Foundation-1.7B and InfiMed-Foundation-4B, two medical-specific MLLMs designed to deliver state-of-the-art performance in medical applications. We combined high-quality general-purpose and medical multimodal data and proposed a novel five-dimensional quality assessment framework to curate high-quality multimodal medical datasets. We employ low-to-high image resolution and multimodal sequence packing to enhance training efficiency, enabling the integration of extensive medical data. Furthermore, a three-stage supervised fine-tuning process ensures effective knowledge extraction for complex medical tasks. Evaluated on the MedEvalKit framework, InfiMed-Foundation-1.7B outperforms Qwen2.5VL-3B, while InfiMed-Foundation-4B surpasses HuatuoGPT-V-7B and MedGemma-27B-IT, demonstrating superior performance in medical visual question answering and diagnostic tasks. By addressing key challenges in data quality, training efficiency, and domain-specific knowledge extraction, our work paves the way for more reliable and effective AI-driven solutions in healthcare. InfiMed-Foundation-4B model is available at https://huggingface.co/InfiX-ai/InfiMed-Foundation-4B{InfiMed-Foundation-4B}.

Mixture of Expert Tuning (MoE-Tuning) has effectively enhanced the performance of general MLLMs with fewer parameters, yet its application in resource-limited medical settings has not been fully explored. To address this gap, we developed MoE-TinyMed, a model tailored for medical applications that significantly lowers parameter demands. In evaluations on the VQA-RAD, SLAKE, and Path-VQA datasets, MoE-TinyMed outperformed LLaVA-Med in all Med-VQA closed settings with just 3.6B parameters. Additionally, a streamlined version with 2B parameters surpassed LLaVA-Med's performance in PathVQA, showcasing its effectiveness in resource-limited healthcare settings.

Multimodal large language models (MLLMs) hold significant potential in medical applications, including disease diagnosis and clinical decision-making. However, these tasks require highly accurate, context-sensitive, and professionally aligned responses, making reliable reward models and judges critical. Despite their importance, medical reward models (MRMs) and judges remain underexplored, with no dedicated benchmarks addressing clinical requirements. Existing benchmarks focus on general MLLM capabilities or evaluate models as solvers, neglecting essential evaluation dimensions like diagnostic accuracy and clinical relevance. To address this, we introduce Med-RewardBench, the first benchmark specifically designed to evaluate MRMs and judges in medical scenarios. Med-RewardBench features a multimodal dataset spanning 13 organ systems and 8 clinical departments, with 1,026 expert-annotated cases. A rigorous three-step process ensures high-quality evaluation data across six clinically critical dimensions. We evaluate 32 state-of-the-art MLLMs, including open-source, proprietary, and medical-specific models, revealing substantial challenges in aligning outputs with expert judgment. Additionally, we develop baseline models that demonstrate substantial performance improvements through fine-tuning.

Multimodal large language models (MLLMs) have demonstrated impressive performance in vision-language tasks across a broad spectrum of domains. However, the large model scale and associated high computational costs pose significant challenges for training and deploying MLLMs on consumer-grade GPUs or edge devices, thereby hindering their widespread application. In this work, we introduce Mini-InternVL, a series of MLLMs with parameters ranging from 1B to 4B, which achieves 90% of the performance with only 5% of the parameters. This significant improvement in efficiency and effectiveness makes our models more accessible and applicable in various real-world scenarios. To further promote the adoption of our models, we develop a unified adaptation framework for Mini-InternVL, which enables our models to transfer and outperform specialized models in downstream tasks, including autonomous driving, medical images, and remote sensing. We believe that our study can provide valuable insights and resources to advance the development of efficient and effective MLLMs. Code is available at https://github.com/OpenGVLab/InternVL.

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

Multimodal large language models (MLLMs) represent an evolutionary expansion in the capabilities of traditional large language models, enabling them to tackle challenges that surpass the scope of purely text-based applications. It leverages the knowledge previously encoded within these language models, thereby enhancing their applicability and functionality in the reign of multimodal contexts. Recent works investigate the adaptation of MLLMs to predict free-form answers as a generative task to solve medical visual question answering (Med-VQA) tasks. In this paper, we propose a parameter efficient framework for fine-tuning MLLM specifically tailored to Med-VQA applications, and empirically validate it on a public benchmark dataset. To accurately measure the performance, we employ human evaluation and the results reveal that our model achieves an overall accuracy of 81.9%, and outperforms the GPT-4v model by a significant margin of 26% absolute accuracy on closed-ended questions. The code will be available here: https://github.com/jinlHe/PeFoMed.

The analysis of 3D medical images is crucial for modern healthcare, yet traditional task-specific models are becoming increasingly inadequate due to limited generalizability across diverse clinical scenarios. Multimodal large language models (MLLMs) offer a promising solution to these challenges. However, existing MLLMs have limitations in fully leveraging the rich, hierarchical information embedded in 3D medical images. Inspired by clinical practice, where radiologists focus on both 3D spatial structure and 2D planar content, we propose Med-2E3, a novel MLLM for 3D medical image analysis that integrates 3D and 2D encoders. To aggregate 2D features more effectively, we design a Text-Guided Inter-Slice (TG-IS) scoring module, which scores the attention of each 2D slice based on slice contents and task instructions. To the best of our knowledge, Med-2E3 is the first MLLM to integrate both 3D and 2D features for 3D medical image analysis. Experiments on a large-scale, open-source 3D medical multimodal benchmark demonstrate that Med-2E3 exhibits task-specific attention distribution and significantly outperforms current state-of-the-art models, with a 14% improvement in report generation and a 5% gain in medical visual question answering (VQA), highlighting the model's potential in addressing complex multimodal clinical tasks. The code will be released upon acceptance.

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.

Multimodal Large Language Models (MLLMs) have demonstrated remarkable effectiveness in various general-domain scenarios, such as visual question answering and image captioning. Recently, researchers have increasingly focused on empowering MLLMs with medical conversational abilities, which hold significant promise for clinical applications. However, medical data presents unique challenges due to its heterogeneous nature -- encompassing diverse modalities including 2D images, 3D volumetric scans, and temporal video sequences. The substantial domain gap and data format inconsistencies across these modalities have hindered the development of unified medical MLLMs. To address these challenges, we propose Fleming-VL, a unified end-to-end framework for comprehensive medical visual understanding across heterogeneous modalities. Fleming-VL tackles this problem from a data-centric perspective through three key strategies: (1) scaling up pretraining by integrating long-context data from both natural and medical-specific domains; (2) complementing fine-tuning with rare medical data, including holistic video analysis and underrepresented 2D modalities such as ultrasound and dermoscopy images; (3) extending existing evaluation frameworks to incorporate 3D volumetric and video understanding benchmarks. Through supervised fine-tuning (SFT) and group relative policy optimization (GRPO), we develop Fleming-VL in multiple model scales. Extensive experiments demonstrate that Fleming-VL achieves state-of-the-art performance across multiple benchmarks, including medical VQA, video QA, and 3D medical image understanding. We publicly release Fleming-VL to promote transparent, reproducible, and auditable progress in medical AI.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.

The rapid development of large language models (LLMs) has been witnessed in recent years. Based on the powerful LLMs, multi-modal LLMs (MLLMs) extend the modality from text to a broader spectrum of domains, attracting widespread attention due to the broader range of application scenarios. As LLMs and MLLMs rely on vast amounts of model parameters and data to achieve emergent capabilities, the importance of data is receiving increasingly widespread attention and recognition. Tracing and analyzing recent data-oriented works for MLLMs, we find that the development of models and data is not two separate paths but rather interconnected. On the one hand, vaster and higher-quality data contribute to better performance of MLLMs, on the other hand, MLLMs can facilitate the development of data. The co-development of multi-modal data and MLLMs requires a clear view of 1) at which development stage of MLLMs can specific data-centric approaches be employed to enhance which capabilities, and 2) by utilizing which capabilities and acting as which roles can models contribute to multi-modal data. To promote the data-model co-development for MLLM community, we systematically review existing works related to MLLMs from the data-model co-development perspective. A regularly maintained project associated with this survey is accessible at https://github.com/modelscope/data-juicer/blob/main/docs/awesome_llm_data.md.

Multimodal Large Language Models (MLLMs) have shown significant potential in medical image analysis. However, their capabilities in interpreting fundus images, a critical skill for ophthalmology, remain under-evaluated. Existing benchmarks lack fine-grained task divisions and fail to provide modular analysis of its two key modules, i.e., large language model (LLM) and vision encoder (VE). This paper introduces FunBench, a novel visual question answering (VQA) benchmark designed to comprehensively evaluate MLLMs' fundus reading skills. FunBench features a hierarchical task organization across four levels (modality perception, anatomy perception, lesion analysis, and disease diagnosis). It also offers three targeted evaluation modes: linear-probe based VE evaluation, knowledge-prompted LLM evaluation, and holistic evaluation. Experiments on nine open-source MLLMs plus GPT-4o reveal significant deficiencies in fundus reading skills, particularly in basic tasks such as laterality recognition. The results highlight the limitations of current MLLMs and emphasize the need for domain-specific training and improved LLMs and VEs.

The recent release of RadGenome-Chest CT has significantly advanced CT-based report generation. However, existing methods primarily focus on global features, making it challenging to capture region-specific details, which may cause certain abnormalities to go unnoticed. To address this, we propose MedRegion-CT, a region-focused Multi-Modal Large Language Model (MLLM) framework, featuring three key innovations. First, we introduce Region Representative (R^2) Token Pooling, which utilizes a 2D-wise pretrained vision model to efficiently extract 3D CT features. This approach generates global tokens representing overall slice features and region tokens highlighting target areas, enabling the MLLM to process comprehensive information effectively. Second, a universal segmentation model generates pseudo-masks, which are then processed by a mask encoder to extract region-centric features. This allows the MLLM to focus on clinically relevant regions, using six predefined region masks. Third, we leverage segmentation results to extract patient-specific attributions, including organ size, diameter, and locations. These are converted into text prompts, enriching the MLLM's understanding of patient-specific contexts. To ensure rigorous evaluation, we conducted benchmark experiments on report generation using the RadGenome-Chest CT. MedRegion-CT achieved state-of-the-art performance, outperforming existing methods in natural language generation quality and clinical relevance while maintaining interpretability. The code for our framework is publicly available.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

The emergence and growing popularity of multimodal large language models (MLLMs) have significant potential to enhance various aspects of daily life, from improving communication to facilitating learning and problem-solving. Mobile phones, as essential daily companions, represent the most effective and accessible deployment platform for MLLMs, enabling seamless integration into everyday tasks. However, deploying MLLMs on mobile phones presents challenges due to limitations in memory size and computational capability, making it difficult to achieve smooth and real-time processing without extensive optimization. In this paper, we present BlueLM-V-3B, an algorithm and system co-design approach specifically tailored for the efficient deployment of MLLMs on mobile platforms. To be specific, we redesign the dynamic resolution scheme adopted by mainstream MLLMs and implement system optimization for hardware-aware deployment to optimize model inference on mobile phones. BlueLM-V-3B boasts the following key highlights: (1) Small Size: BlueLM-V-3B features a language model with 2.7B parameters and a vision encoder with 400M parameters. (2) Fast Speed: BlueLM-V-3B achieves a generation speed of 24.4 token/s on the MediaTek Dimensity 9300 processor with 4-bit LLM weight quantization. (3) Strong Performance: BlueLM-V-3B has attained the highest average score of 66.1 on the OpenCompass benchmark among models with leq 4B parameters and surpassed a series of models with much larger parameter sizes (e.g., MiniCPM-V-2.6, InternVL2-8B).

Multimodal Large Language Model (MLLM) have demonstrated strong generalization capabilities across diverse distributions and tasks, largely due to extensive pre-training datasets. Fine-tuning MLLM has become a common practice to improve performance on specific downstream tasks. However, during fine-tuning, MLLM often faces the risk of forgetting knowledge acquired during pre-training, which can result in a decline in generalization abilities. To balance the trade-off between generalization and specialization, we propose measuring the parameter importance for both pre-trained and fine-tuning distributions, based on frozen pre-trained weight magnitude and accumulated fine-tuning gradient values. We further apply an importance-aware weight allocation strategy, selectively updating relatively important parameters for downstream tasks. We conduct empirical evaluations on both image captioning and visual question-answering tasks using various MLLM architectures. The comprehensive experimental analysis demonstrates the effectiveness of the proposed solution, highlighting the efficiency of the crucial modules in enhancing downstream specialization performance while mitigating generalization degradation in MLLM Fine-Tuning.

Multimodal large language models (MLLMs) like LLaVA and GPT-4(V) enable general-purpose conversations about images with the language modality. As off-the-shelf MLLMs may have limited capabilities on images from domains like dermatology and agriculture, they must be fine-tuned to unlock domain-specific applications. The prevalent architecture of current open-source MLLMs comprises two major modules: an image-language (cross-modal) projection network and a large language model. It is desirable to understand the roles of these two modules in modeling domain-specific visual attributes to inform the design of future models and streamline the interpretability efforts on the current models. To this end, via experiments on 4 datasets and under 2 fine-tuning settings, we find that as the MLLM is fine-tuned, it indeed gains domain-specific visual capabilities, but the updates do not lead to the projection extracting relevant domain-specific visual attributes. Our results indicate that the domain-specific visual attributes are modeled by the LLM, even when only the projection is fine-tuned. Through this study, we offer a potential reinterpretation of the role of cross-modal projections in MLLM architectures. Projection webpage: https://claws-lab.github.io/projection-in-MLLMs/

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Multi-modal Large Language Models (MLLMs) integrate visual and linguistic reasoning to address complex tasks such as image captioning and visual question answering. While MLLMs demonstrate remarkable versatility, MLLMs appears limited performance on special applications. But tuning MLLMs for downstream tasks encounters two key challenges: Task-Expert Specialization, where distribution shifts between pre-training and target datasets constrain target performance, and Open-World Stabilization, where catastrophic forgetting erases the model general knowledge. In this work, we systematically review recent advancements in MLLM tuning methodologies, classifying them into three paradigms: (I) Selective Tuning, (II) Additive Tuning, and (III) Reparameterization Tuning. Furthermore, we benchmark these tuning strategies across popular MLLM architectures and diverse downstream tasks to establish standardized evaluation analysis and systematic tuning principles. Finally, we highlight several open challenges in this domain and propose future research directions. To facilitate ongoing progress in this rapidly evolving field, we provide a public repository that continuously tracks developments: https://github.com/WenkeHuang/Awesome-MLLM-Tuning.

Multimodal Large Language Models (mLLMs) are trained on a large amount of text-image data. While most mLLMs are trained on caption-like data only, Alayrac et al. [2022] showed that additionally training them on interleaved sequences of text and images can lead to the emergence of in-context learning capabilities. However, the dataset they used, M3W, is not public and is only in English. There have been attempts to reproduce their results but the released datasets are English-only. In contrast, current multilingual and multimodal datasets are either composed of caption-like only or medium-scale or fully private data. This limits mLLM research for the 7,000 other languages spoken in the world. We therefore introduce mOSCAR, to the best of our knowledge the first large-scale multilingual and multimodal document corpus crawled from the web. It covers 163 languages, 315M documents, 214B tokens and 1.2B images. We carefully conduct a set of filtering and evaluation steps to make sure mOSCAR is sufficiently safe, diverse and of good quality. We additionally train two types of multilingual model to prove the benefits of mOSCAR: (1) a model trained on a subset of mOSCAR and captioning data and (2) a model train on captioning data only. The model additionally trained on mOSCAR shows a strong boost in few-shot learning performance across various multilingual image-text tasks and benchmarks, confirming previous findings for English-only mLLMs.

In recent years, large language models have had a very impressive performance, which largely contributed to the development and application of artificial intelligence, and the parameters and performance of the models are still growing rapidly. In particular, multimodal large language models (MLLM) can combine multiple modalities such as pictures, videos, sounds, texts, etc., and have great potential in various tasks. However, most MLLMs require very high computational resources, which is a major challenge for most researchers and developers. In this paper, we explored the utility of small-scale MLLMs and applied small-scale MLLMs to the field of autonomous driving. We hope that this will advance the application of MLLMs in real-world scenarios.

Multimodal large language models (MLLMs) have advanced clinical tasks for common conditions, but their performance on rare diseases remains largely untested. In rare-disease scenarios, clinicians often lack prior clinical knowledge, forcing them to rely strictly on case-level evidence for clinical judgments. Existing benchmarks predominantly evaluate common-condition, single-image settings, leaving multimodal and multi-image evidence integration under rare-disease data scarcity systematically unevaluated. We introduce MMRareBench, to our knowledge the first rare-disease benchmark jointly evaluating multimodal and multi-image clinical capability across four workflow-aligned tracks: diagnosis, treatment planning, cross-image evidence alignment, and examination suggestion. The benchmark comprises 1,756 question-answer pairs with 7,958 associated medical images curated from PMC case reports, with Orphanet-anchored ontology alignment, track-specific leakage control, evidence-grounded annotations, and a two-level evaluation protocol. A systematic evaluation of 23 MLLMs reveals fragmented capability profiles and universally low treatment-planning performance, with medical-domain models trailing general-purpose MLLMs substantially on multi-image tracks despite competitive diagnostic scores. These patterns are consistent with a capacity dilution effect: medical fine-tuning can narrow the diagnostic gap but may erode the compositional multi-image capability that rare-disease evidence integration demands.

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose Knowledge to Sight (K2Sight), a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in mAP_{50}. Code and models: https://lijunrio.github.io/K2Sight/{SOTAPink{https://lijunrio.github.io/K2Sight/}}.

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

In an era defined by the explosive growth of data and rapid technological advancements, Multimodal Large Language Models (MLLMs) stand at the forefront of artificial intelligence (AI) systems. Designed to seamlessly integrate diverse data types-including text, images, videos, audio, and physiological sequences-MLLMs address the complexities of real-world applications far beyond the capabilities of single-modality systems. In this paper, we systematically sort out the applications of MLLM in multimodal tasks such as natural language, vision, and audio. We also provide a comparative analysis of the focus of different MLLMs in the tasks, and provide insights into the shortcomings of current MLLMs, and suggest potential directions for future research. Through these discussions, this paper hopes to provide valuable insights for the further development and application of MLLM.

The success of large language models (LLMs) has fostered a new research trend of multi-modality large language models (MLLMs), which changes the paradigm of various fields in computer vision. Though MLLMs have shown promising results in numerous high-level vision and vision-language tasks such as VQA and text-to-image, no works have demonstrated how low-level vision tasks can benefit from MLLMs. We find that most current MLLMs are blind to low-level features due to their design of vision modules, thus are inherently incapable for solving low-level vision tasks. In this work, we purpose LM4LV, a framework that enables a FROZEN LLM to solve a range of low-level vision tasks without any multi-modal data or prior. This showcases the LLM's strong potential in low-level vision and bridges the gap between MLLMs and low-level vision tasks. We hope this work can inspire new perspectives on LLMs and deeper understanding of their mechanisms.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

This paper provides a comprehensive survey of the latest research on multilingual large language models (MLLMs). MLLMs not only are able to understand and generate language across linguistic boundaries, but also represent an important advancement in artificial intelligence. We first discuss the architecture and pre-training objectives of MLLMs, highlighting the key components and methodologies that contribute to their multilingual capabilities. We then discuss the construction of multilingual pre-training and alignment datasets, underscoring the importance of data quality and diversity in enhancing MLLM performance. An important focus of this survey is on the evaluation of MLLMs. We present a detailed taxonomy and roadmap covering the assessment of MLLMs' cross-lingual knowledge, reasoning, alignment with human values, safety, interpretability and specialized applications. Specifically, we extensively discuss multilingual evaluation benchmarks and datasets, and explore the use of LLMs themselves as multilingual evaluators. To enhance MLLMs from black to white boxes, we also address the interpretability of multilingual capabilities, cross-lingual transfer and language bias within these models. Finally, we provide a comprehensive review of real-world applications of MLLMs across diverse domains, including biology, medicine, computer science, mathematics and law. We showcase how these models have driven innovation and improvements in these specialized fields while also highlighting the challenges and opportunities in deploying MLLMs within diverse language communities and application scenarios. We listed the paper related in this survey and publicly available at https://github.com/tjunlp-lab/Awesome-Multilingual-LLMs-Papers.

Due to the necessity for precise treatment planning, the use of panoramic X-rays to identify different dental diseases has tremendously increased. Although numerous ML models have been developed for the interpretation of panoramic X-rays, there has not been an end-to-end model developed that can identify problematic teeth with dental enumeration and associated diagnoses at the same time. To develop such a model, we structure the three distinct types of annotated data hierarchically following the FDI system, the first labeled with only quadrant, the second labeled with quadrant-enumeration, and the third fully labeled with quadrant-enumeration-diagnosis. To learn from all three hierarchies jointly, we introduce a novel diffusion-based hierarchical multi-label object detection framework by adapting a diffusion-based method that formulates object detection as a denoising diffusion process from noisy boxes to object boxes. Specifically, to take advantage of the hierarchically annotated data, our method utilizes a novel noisy box manipulation technique by adapting the denoising process in the diffusion network with the inference from the previously trained model in hierarchical order. We also utilize a multi-label object detection method to learn efficiently from partial annotations and to give all the needed information about each abnormal tooth for treatment planning. Experimental results show that our method significantly outperforms state-of-the-art object detection methods, including RetinaNet, Faster R-CNN, DETR, and DiffusionDet for the analysis of panoramic X-rays, demonstrating the great potential of our method for hierarchically and partially annotated datasets. The code and the data are available at: https://github.com/ibrahimethemhamamci/HierarchicalDet.

Expanding the long-context capabilities of Multi-modal Large Language Models~(MLLMs) is crucial for video understanding, high-resolution image understanding, and multi-modal agents. This involves a series of systematic optimizations, including model architecture, data construction and training strategy, particularly addressing challenges such as degraded performance with more images and high computational costs. In this paper, we adapt the model architecture to a hybrid of Mamba and Transformer blocks, approach data construction with both temporal and spatial dependencies among multiple images and employ a progressive training strategy. The released model LongLLaVA~(Long-Context Large Language and Vision Assistant) is the first hybrid MLLM, which achieved a better balance between efficiency and effectiveness. LongLLaVA not only achieves competitive results across various benchmarks, but also maintains high throughput and low memory consumption. Especially, it could process nearly a thousand images on a single A100 80GB GPU, showing promising application prospects for a wide range of tasks.

A key frontier for Multimodal Large Language Models (MLLMs) is the ability to perform deep mathematical and spatial reasoning directly from images, moving beyond their established success in semantic description. Mathematical surface plots provide a rigorous testbed for this capability, as they isolate the task of reasoning from the semantic noise common in natural images. To measure progress on this frontier, we introduce MaRVL-QA (Mathematical Reasoning over Visual Landscapes), a new benchmark designed to quantitatively evaluate these core reasoning skills. The benchmark comprises two novel tasks: Topological Counting, identifying and enumerating features like local maxima; and Transformation Recognition, recognizing applied geometric transformations. Generated from a curated library of functions with rigorous ambiguity filtering, our evaluation on MaRVL-QA reveals that even state-of-the-art MLLMs struggle significantly, often resorting to superficial heuristics instead of robust spatial reasoning. MaRVL-QA provides a challenging new tool for the research community to measure progress, expose model limitations, and guide the development of MLLMs with more profound reasoning abilities.

The success of Large Language Models (LLM) has led researchers to explore Multimodal Large Language Models (MLLM) for unified visual and linguistic understanding. However, the increasing model size and computational complexity of MLLM limit their use in resource-constrained environments. Small-scale MLLM (s-MLLM) aims to retain the capabilities of the large-scale model (l-MLLM) while reducing computational demands, but resulting in a significant decline in performance. To address the aforementioned issues, we propose a novel LLaVA-KD framework to transfer knowledge from l-MLLM to s-MLLM. Specifically, we introduce Multimodal Distillation (MDist) to minimize the divergence between the visual-textual output distributions of l-MLLM and s-MLLM, and Relation Distillation (RDist) to transfer l-MLLM's ability to model correlations between visual features. Additionally, we propose a three-stage training scheme to fully exploit the potential of s-MLLM: 1) Distilled Pre-Training to align visual-textual representations, 2) Supervised Fine-Tuning to equip the model with multimodal understanding, and 3) Distilled Fine-Tuning to further transfer l-MLLM capabilities. Our approach significantly improves performance without altering the small model's architecture. Extensive experiments and ablation studies validate the effectiveness of each proposed component. Code will be available at https://github.com/caiyuxuan1120/LLaVA-KD.

Although vision models such as Contrastive Language-Image Pre-Training (CLIP) show impressive generalization performance, their zero-shot robustness is still limited under Out-of-Distribution (OOD) scenarios without fine-tuning. Instead of undesirably providing human supervision as commonly done, it is possible to take advantage of Multi-modal Large Language Models (MLLMs) that hold powerful visual understanding abilities. However, MLLMs are shown to struggle with vision problems due to the incompatibility of tasks, thus hindering their utilization. In this paper, we propose to effectively leverage MLLMs to conduct Machine Vision Therapy which aims to rectify the noisy predictions from vision models. By fine-tuning with the denoised labels, the learning model performance can be boosted in an unsupervised manner. To solve the incompatibility issue, we propose a novel Denoising In-Context Learning (DICL) strategy to align vision tasks with MLLMs. Concretely, by estimating a transition matrix that captures the probability of one class being confused with another, an instruction containing a correct exemplar and an erroneous one from the most probable noisy class can be constructed. Such an instruction can help any MLLMs with ICL ability to detect and rectify incorrect predictions of vision models. Through extensive experiments on ImageNet, WILDS, DomainBed, and other OOD datasets, we carefully validate the quantitative and qualitative effectiveness of our method. Our code is available at https://github.com/tmllab/Machine_Vision_Therapy.

Do we fully leverage the potential of visual encoder in Multimodal Large Language Models (MLLMs)? The recent outstanding performance of MLLMs in multimodal understanding has garnered broad attention from both academia and industry. In the current MLLM rat race, the focus seems to be predominantly on the linguistic side. We witness the rise of larger and higher-quality instruction datasets, as well as the involvement of larger-sized LLMs. Yet, scant attention has been directed towards the visual signals utilized by MLLMs, often assumed to be the final high-level features extracted by a frozen visual encoder. In this paper, we introduce the Dense Connector - a simple, effective, and plug-and-play vision-language connector that significantly enhances existing MLLMs by leveraging multi-layer visual features, with minimal additional computational overhead. Furthermore, our model, trained solely on images, showcases remarkable zero-shot capabilities in video understanding as well. Experimental results across various vision encoders, image resolutions, training dataset scales, varying sizes of LLMs (2.7B->70B), and diverse architectures of MLLMs (e.g., LLaVA and Mini-Gemini) validate the versatility and scalability of our approach, achieving state-of-the-art performance on across 19 image and video benchmarks. We hope that this work will provide valuable experience and serve as a basic module for future MLLM development.

Multimodal large language models (MLLMs) are designed to process and integrate information from multiple sources, such as text, speech, images, and videos. Despite its success in language understanding, it is critical to evaluate the performance of downstream tasks for better human-centric applications. This paper assesses the application of MLLMs with 5 crucial abilities for affective computing, spanning from visual affective tasks and reasoning tasks. The results show that \gpt has high accuracy in facial action unit recognition and micro-expression detection while its general facial expression recognition performance is not accurate. We also highlight the challenges of achieving fine-grained micro-expression recognition and the potential for further study and demonstrate the versatility and potential of \gpt for handling advanced tasks in emotion recognition and related fields by integrating with task-related agents for more complex tasks, such as heart rate estimation through signal processing. In conclusion, this paper provides valuable insights into the potential applications and challenges of MLLMs in human-centric computing. Our interesting examples are at https://github.com/EnVision-Research/GPT4Affectivity.

Recent Multimodal Large Language Models (MLLMs) have demonstrated significant progress in perceiving and reasoning over multimodal inquiries, ushering in a new research era for foundation models. However, vision-language misalignment in MLLMs has emerged as a critical challenge, where the textual responses generated by these models are not factually aligned with the given text-image inputs. Existing efforts to address vision-language misalignment have focused on developing specialized vision-language connectors or leveraging visual instruction tuning from diverse domains. In this paper, we tackle this issue from a fundamental yet unexplored perspective by revisiting the core architecture of MLLMs. Most MLLMs are typically built on decoder-only LLMs consisting of a causal attention mechanism, which limits the ability of earlier modalities (e.g., images) to incorporate information from later modalities (e.g., text). To address this problem, we propose AKI, a novel MLLM that unlocks causal attention into modality-mutual attention (MMA) to enable image tokens to attend to text tokens. This simple yet effective design allows AKI to achieve superior performance in 12 multimodal understanding benchmarks (+7.2% on average) without introducing additional parameters and increasing training time. Our MMA design is intended to be generic, allowing for application across various modalities, and scalable to accommodate diverse multimodal scenarios. The code is publicly available at https://github.com/sony/aki, and we will release our AKI-4B model to encourage further advancements in MLLMs across various directions.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Pretrained Multimodal Large Language Models (MLLMs) are increasingly deployed in medical AI systems for clinical reasoning, diagnosis support, and report generation. However, their training on sensitive patient data raises critical privacy and compliance challenges under regulations such as HIPAA and GDPR, which enforce the "right to be forgotten". Unlearning, the process of tuning models to selectively remove the influence of specific training data points, offers a potential solution, yet its effectiveness in complex medical settings remains underexplored. To systematically study this, we introduce MedForget, a Hierarchy-Aware Multimodal Unlearning Testbed with explicit retain and forget splits and evaluation sets containing rephrased variants. MedForget models hospital data as a nested hierarchy (Institution -> Patient -> Study -> Section), enabling fine-grained assessment across eight organizational levels. The benchmark contains 3840 multimodal (image, question, answer) instances, each hierarchy level having a dedicated unlearning target, reflecting distinct unlearning challenges. Experiments with four SOTA unlearning methods on three tasks (generation, classification, cloze) show that existing methods struggle to achieve complete, hierarchy-aware forgetting without reducing diagnostic performance. To test whether unlearning truly deletes hierarchical pathways, we introduce a reconstruction attack that progressively adds hierarchical level context to prompts. Models unlearned at a coarse granularity show strong resistance, while fine-grained unlearning leaves models vulnerable to such reconstruction. MedForget provides a practical, HIPAA-aligned testbed for building compliant medical AI systems.

Multimodal Large Language Model (MLLM) relies on the powerful LLM to perform multimodal tasks, showing amazing emergent abilities in recent studies, such as writing poems based on an image. However, it is difficult for these case studies to fully reflect the performance of MLLM, lacking a comprehensive evaluation. In this paper, we fill in this blank, presenting the first MLLM Evaluation benchmark MME. It measures both perception and cognition abilities on a total of 14 subtasks. In order to avoid data leakage that may arise from direct use of public datasets for evaluation, the annotations of instruction-answer pairs are all manually designed. The concise instruction design allows us to fairly compare MLLMs, instead of struggling in prompt engineering. Besides, with such an instruction, we can also easily carry out quantitative statistics. A total of 12 advanced MLLMs are comprehensively evaluated on our MME, which not only suggests that existing MLLMs still have a large room for improvement, but also reveals the potential directions for the subsequent model optimization.

Incentivizing the reasoning ability of Multimodal Large Language Models (MLLMs) is essential for medical applications to transparently analyze medical scans and provide reliable diagnosis. However, existing medical MLLMs rely solely on internal knowledge during reasoning, leading to hallucinated reasoning and factual inaccuracies when encountering cases beyond their training scope. Although recent Agentic Retrieval-Augmented Generation (RAG) methods elicit the medical model's proactive retrieval ability during reasoning, they are confined to unimodal LLMs, neglecting the crucial visual information during reasoning and retrieval. Consequently, we propose the first Multimodal Medical Reasoning-with-Retrieval framework, Med-RwR, which actively retrieves external knowledge by querying observed symptoms or domain-specific medical concepts during reasoning. Specifically, we design a two-stage reinforcement learning strategy with tailored rewards that stimulate the model to leverage both visual diagnostic findings and textual clinical information for effective retrieval. Building on this foundation, we further propose a Confidence-Driven Image Re-retrieval (CDIR) method for test-time scaling when low prediction confidence is detected. Evaluation on various public medical benchmarks demonstrates Med-RwR's significant improvements over baseline models, proving the effectiveness of enhancing reasoning capabilities with external knowledge integration. Furthermore, Med-RwR demonstrates remarkable generalizability to unfamiliar domains, evidenced by 8.8% performance gain on our proposed EchoCardiography Benchmark (ECBench), despite the scarcity of echocardiography data in the training corpus. Our data, model, and codes will be made publicly available at https://github.com/xmed-lab/Med-RwR.

Multi-modal large language models (MLLMs) have advanced general-purpose video understanding but struggle with long, high-resolution videos -- they process every pixel equally in their vision transformers (ViTs) or LLMs despite significant spatiotemporal redundancy. We introduce AutoGaze, a lightweight module that removes redundant patches before processed by a ViT or an MLLM. Trained with next-token prediction and reinforcement learning, AutoGaze autoregressively selects a minimal set of multi-scale patches that can reconstruct the video within a user-specified error threshold, eliminating redundancy while preserving information. Empirically, AutoGaze reduces visual tokens by 4x-100x and accelerates ViTs and MLLMs by up to 19x, enabling scaling MLLMs to 1K-frame 4K-resolution videos and achieving superior results on video benchmarks (e.g., 67.0% on VideoMME). Furthermore, we introduce HLVid: the first high-resolution, long-form video QA benchmark with 5-minute 4K-resolution videos, where an MLLM scaled with AutoGaze improves over the baseline by 10.1% and outperforms the previous best MLLM by 4.5%. Project page: https://autogaze.github.io/.

We present DualFocus, a novel framework for integrating macro and micro perspectives within multi-modal large language models (MLLMs) to enhance vision-language task performance. Current MLLMs typically singularly focus on inputs at a predefined resolution, resulting in deficiencies in detailed questions involving local regions. We introduced a DualFocus mechanism where the model concentrates on the image from a macro perspective, responses to the question, and identifies suitable sub-regions to zoom in for subsequent micro perspective analysis. Via the integration of answers from both macro and micro perspectives, the model is adept at addressing tasks that encompass global, detailed, and combined considerations. To endows the DualFocus mechanism in MLLMs, we curated a tailored dataset derived from the Visual Genome (VG) and adapted it to align with the training regimen of DualFocus. Through comparative studies across different model sizes and benchmarks, we demonstrate DualFocus's superiority in balancing detailed examination with holistic insight, significantly reducing hallucination instances in MLLMs and improving their performance in various vision-language tasks.

The recent surge of Multimodal Large Language Models (MLLMs) has fundamentally reshaped the landscape of AI research and industry, shedding light on a promising path toward the next AI milestone. However, significant challenges remain preventing MLLMs from being practical in real-world applications. The most notable challenge comes from the huge cost of running an MLLM with a massive number of parameters and extensive computation. As a result, most MLLMs need to be deployed on high-performing cloud servers, which greatly limits their application scopes such as mobile, offline, energy-sensitive, and privacy-protective scenarios. In this work, we present MiniCPM-V, a series of efficient MLLMs deployable on end-side devices. By integrating the latest MLLM techniques in architecture, pretraining and alignment, the latest MiniCPM-Llama3-V 2.5 has several notable features: (1) Strong performance, outperforming GPT-4V-1106, Gemini Pro and Claude 3 on OpenCompass, a comprehensive evaluation over 11 popular benchmarks, (2) strong OCR capability and 1.8M pixel high-resolution image perception at any aspect ratio, (3) trustworthy behavior with low hallucination rates, (4) multilingual support for 30+ languages, and (5) efficient deployment on mobile phones. More importantly, MiniCPM-V can be viewed as a representative example of a promising trend: The model sizes for achieving usable (e.g., GPT-4V) level performance are rapidly decreasing, along with the fast growth of end-side computation capacity. This jointly shows that GPT-4V level MLLMs deployed on end devices are becoming increasingly possible, unlocking a wider spectrum of real-world AI applications in the near future.

Multimodal large language models (MLLMs) have rapidly advanced, yet their adoption in medicine remains limited by gaps in domain coverage, modality alignment, and grounded reasoning. In this work, we introduce MedMO, a medical foundation model built upon a generalized MLLM architecture and trained exclusively on large-scale, domain-specific data. MedMO follows a multi-stage training recipe: (i) cross-modal pretraining to align heterogeneous visual encoders with a medical language backbone; (ii) instruction tuning on multi-task supervision that spans captioning, VQA, report generation, retrieval, and grounded disease localization with bounding boxes; and (iii) reinforcement learning with verifiable rewards that combine factuality checks with a box-level GIoU reward to strengthen spatial grounding and step-by-step reasoning in complex clinical scenarios. MedMO consistently outperforms strong open-source medical MLLMs across multiple modalities and tasks. On VQA benchmarks, MedMO achieves an average accuracy improvement of +13.7% over the baseline and performs within 1.9% of the SOTA Fleming-VL. For text-based QA, it attains +6.9% over the baseline and +14.5% over Fleming-VL. In medical report generation, MedMO delivers significant gains in both semantic and clinical accuracy. Moreover, it exhibits strong grounding capability, achieving an IoU improvement of +40.4 over the baseline and +37.0% over Fleming-VL, underscoring its robust spatial reasoning and localization performance. Evaluations across radiology, ophthalmology, and pathology-microscopy confirm MedMO's broad cross-modality generalization. We release two versions of MedMO: 4B and 8B. Project is available at https://genmilab.github.io/MedMO-Page

Current Multimodal Large Language Models exhibit very strong performance for several demanding tasks. While commercial MLLMs deliver acceptable performance in low-resource languages, comparable results remain unattained within the open science community. In this paper, we aim to develop a strong MLLM for a low-resource language, namely Basque. For that purpose, we develop our own training and evaluation image-text datasets. Using two different Large Language Models as backbones, the Llama-3.1-Instruct model and a Basque-adapted variant called Latxa, we explore several data mixtures for training. We show that: i) low ratios of Basque multimodal data (around 20%) are already enough to obtain solid results on Basque benchmarks, and ii) contrary to expected, a Basque instructed backbone LLM is not required to obtain a strong MLLM in Basque. Our results pave the way to develop MLLMs for other low-resource languages by openly releasing our resources.

Multimodal LLMs (MLLMs) are the natural extension of large language models to handle multimodal inputs, combining text and image data. They have recently garnered attention due to their capability to address complex tasks involving both modalities. However, their effectiveness is limited to the knowledge acquired during training, which restricts their practical utility. In this work, we introduce a novel method to enhance the adaptability of MLLMs by integrating external knowledge sources. Our proposed model, Reflective LLaVA (ReflectiVA), utilizes reflective tokens to dynamically determine the need for external knowledge and predict the relevance of information retrieved from an external database. Tokens are trained following a two-stage two-model training recipe. This ultimately enables the MLLM to manage external knowledge while preserving fluency and performance on tasks where external knowledge is not needed. Through our experiments, we demonstrate the efficacy of ReflectiVA for knowledge-based visual question answering, highlighting its superior performance compared to existing methods. Source code and trained models are publicly available at https://github.com/aimagelab/ReflectiVA.

Multimodal Large Language Model (MLLM) recently has been a new rising research hotspot, which uses powerful Large Language Models (LLMs) as a brain to perform multimodal tasks. The surprising emergent capabilities of MLLM, such as writing stories based on images and OCR-free math reasoning, are rare in traditional methods, suggesting a potential path to artificial general intelligence. In this paper, we aim to trace and summarize the recent progress of MLLM. First of all, we present the formulation of MLLM and delineate its related concepts. Then, we discuss the key techniques and applications, including Multimodal Instruction Tuning (M-IT), Multimodal In-Context Learning (M-ICL), Multimodal Chain of Thought (M-CoT), and LLM-Aided Visual Reasoning (LAVR). Finally, we discuss existing challenges and point out promising research directions. In light of the fact that the era of MLLM has only just begun, we will keep updating this survey and hope it can inspire more research. An associated GitHub link collecting the latest papers is available at https://github.com/BradyFU/Awesome-Multimodal-Large-Language-Models.

As the research of Multimodal Large Language Models (MLLMs) becomes popular, an advancing MLLM model is typically required to handle various textual and visual tasks (e.g., VQA, Detection, OCR, and ChartQA) simultaneously for real-world applications. However, due to the significant differences in representation and distribution among data from various tasks, simply mixing data of all tasks together leads to the well-known``multi-task conflict" issue, resulting in performance degradation across various tasks. To address this issue, we propose Awaker2.5-VL, a Mixture of Experts~(MoE) architecture suitable for MLLM, which acquires the multi-task capabilities through multiple sparsely activated experts. To speed up the training and inference of Awaker2.5-VL, each expert in our model is devised as a low-rank adaptation (LoRA) structure. Extensive experiments on multiple latest benchmarks demonstrate the effectiveness of Awaker2.5-VL. The code and model weight are released in our Project Page: https://github.com/MetabrainAGI/Awaker.

Recent advancements indicate that scaling up Multimodal Large Language Models (MLLMs) effectively enhances performance on downstream multimodal tasks. The prevailing MLLM paradigm, e.g., LLaVA, transforms visual features into text-like tokens using a static vision-language mapper, thereby enabling static LLMs to develop the capability to comprehend visual information through visual instruction tuning. Although promising, the static tuning strategy~The static tuning refers to the trained model with static parameters. that shares the same parameters may constrain performance across different downstream multimodal tasks. In light of this, we introduce HyperLLaVA, which involves adaptive tuning of the projector and LLM parameters, in conjunction with a dynamic visual expert and language expert, respectively. These experts are derived from HyperNetworks, which generates adaptive parameter shifts through visual and language guidance, enabling dynamic projector and LLM modeling in two-stage training. Our experiments demonstrate that our solution significantly surpasses LLaVA on existing MLLM benchmarks, including MME, MMBench, SEED-Bench, and LLaVA-Bench. ~Our project is available on the link https://github.com/DCDmllm/HyperLLaVA.

Recently, there has been significant interest in enhancing the capability of multimodal large language models (MLLMs) to process high-resolution images. Most existing methods focus on adopting a cropping strategy to improve the ability of multimodal large language models to understand image details. However, this cropping operation inevitably causes the segmentation of objects and connected areas, which impairs the MLLM's ability to recognize small or irregularly shaped objects or text. This issue is particularly evident in lightweight MLLMs. Addressing this issue, we propose Mini-Monkey, a lightweight MLLM that incorporates a plug-and-play method called multi-scale adaptive crop strategy (MSAC). Mini-Monkey adaptively generates multi-scale representations, allowing it to select non-segmented objects from various scales. To mitigate the computational overhead introduced by MSAC, we propose a Scale Compression Mechanism (SCM), which effectively compresses image tokens. Mini-Monkey achieves state-of-the-art performance among 2B-parameter MLLMs. It not only demonstrates leading performance on a variety of general multimodal understanding tasks but also shows consistent improvements in document understanding capabilities. On the OCRBench, Mini-Monkey achieves a score of 802, outperforming 8B-parameter state-of-the-art model InternVL2-8B. Besides, our model and training strategy are very efficient, which can be trained with only eight RTX 3090. The code is available at https://github.com/Yuliang-Liu/Monkey.

Recent years have witnessed the rapid development of general multimodal large language models (MLLMs). However, adapting general MLLMs to specific domains, such as scientific fields and industrial applications, remains less explored. This paper systematically investigates domain adaptation of MLLMs through post-training, focusing on data synthesis, training pipelines, and task evaluation. (1) Data Synthesis: Using open-source models, we develop a visual instruction synthesizer that effectively generates diverse visual instruction tasks from domain-specific image-caption pairs. Our synthetic tasks surpass those generated by manual rules, GPT-4, and GPT-4V in enhancing the domain-specific performance of MLLMs. (2) Training Pipeline: While the two-stage training--initially on image-caption pairs followed by visual instruction tasks--is commonly adopted for developing general MLLMs, we apply a single-stage training pipeline to enhance task diversity for domain-specific post-training. (3) Task Evaluation: We conduct experiments in two domains, biomedicine and food, by post-training MLLMs of different sources and scales (e.g., Qwen2-VL-2B, LLaVA-v1.6-8B, Llama-3.2-11B), and then evaluating MLLM performance on various domain-specific tasks. To support further research in MLLM domain adaptation, we will open-source our implementations.

We introduce InternVL 2.5, an advanced multimodal large language model (MLLM) series that builds upon InternVL 2.0, maintaining its core model architecture while introducing significant enhancements in training and testing strategies as well as data quality. In this work, we delve into the relationship between model scaling and performance, systematically exploring the performance trends in vision encoders, language models, dataset sizes, and test-time configurations. Through extensive evaluations on a wide range of benchmarks, including multi-discipline reasoning, document understanding, multi-image / video understanding, real-world comprehension, multimodal hallucination detection, visual grounding, multilingual capabilities, and pure language processing, InternVL 2.5 exhibits competitive performance, rivaling leading commercial models such as GPT-4o and Claude-3.5-Sonnet. Notably, our model is the first open-source MLLMs to surpass 70% on the MMMU benchmark, achieving a 3.7-point improvement through Chain-of-Thought (CoT) reasoning and showcasing strong potential for test-time scaling. We hope this model contributes to the open-source community by setting new standards for developing and applying multimodal AI systems. HuggingFace demo see https://huggingface.co/spaces/OpenGVLab/InternVL

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Machine translation is indispensable in healthcare for enabling the global dissemination of medical knowledge across languages. However, complex medical terminology poses unique challenges to achieving adequate translation quality and accuracy. This study introduces a novel "LLMs-in-the-loop" approach to develop supervised neural machine translation models optimized specifically for medical texts. While large language models (LLMs) have demonstrated powerful capabilities, this research shows that small, specialized models trained on high-quality in-domain (mostly synthetic) data can outperform even vastly larger LLMs. Custom parallel corpora in six languages were compiled from scientific articles, synthetically generated clinical documents, and medical texts. Our LLMs-in-the-loop methodology employs synthetic data generation, rigorous evaluation, and agent orchestration to enhance performance. We developed small medical translation models using the MarianMT base model. We introduce a new medical translation test dataset to standardize evaluation in this domain. Assessed using BLEU, METEOR, ROUGE, and BERT scores on this test set, our MarianMT-based models outperform Google Translate, DeepL, and GPT-4-Turbo. Results demonstrate that our LLMs-in-the-loop approach, combined with fine-tuning high-quality, domain-specific data, enables specialized models to outperform general-purpose and some larger systems. This research, part of a broader series on expert small models, paves the way for future healthcare-related AI developments, including deidentification and bio-medical entity extraction models. Our study underscores the potential of tailored neural translation models and the LLMs-in-the-loop methodology to advance the field through improved data generation, evaluation, agent, and modeling techniques.

Sequential recommendation (SR) systems have evolved significantly over the past decade, transitioning from traditional collaborative filtering to deep learning approaches and, more recently, to large language models (LLMs). While the adoption of LLMs has driven substantial advancements, these models inherently lack collaborative filtering information, relying primarily on textual content data neglecting other modalities and thus failing to achieve optimal recommendation performance. To address this limitation, we propose Molar, a Multimodal large language sequential recommendation framework that integrates multiple content modalities with ID information to capture collaborative signals effectively. Molar employs an MLLM to generate unified item representations from both textual and non-textual data, facilitating comprehensive multimodal modeling and enriching item embeddings. Additionally, it incorporates collaborative filtering signals through a post-alignment mechanism, which aligns user representations from content-based and ID-based models, ensuring precise personalization and robust performance. By seamlessly combining multimodal content with collaborative filtering insights, Molar captures both user interests and contextual semantics, leading to superior recommendation accuracy. Extensive experiments validate that Molar significantly outperforms traditional and LLM-based baselines, highlighting its strength in utilizing multimodal data and collaborative signals for sequential recommendation tasks. The source code is available at https://anonymous.4open.science/r/Molar-8B06/.

We present MM1.5, a new family of multimodal large language models (MLLMs) designed to enhance capabilities in text-rich image understanding, visual referring and grounding, and multi-image reasoning. Building upon the MM1 architecture, MM1.5 adopts a data-centric approach to model training, systematically exploring the impact of diverse data mixtures across the entire model training lifecycle. This includes high-quality OCR data and synthetic captions for continual pre-training, as well as an optimized visual instruction-tuning data mixture for supervised fine-tuning. Our models range from 1B to 30B parameters, encompassing both dense and mixture-of-experts (MoE) variants, and demonstrate that careful data curation and training strategies can yield strong performance even at small scales (1B and 3B). Additionally, we introduce two specialized variants: MM1.5-Video, designed for video understanding, and MM1.5-UI, tailored for mobile UI understanding. Through extensive empirical studies and ablations, we provide detailed insights into the training processes and decisions that inform our final designs, offering valuable guidance for future research in MLLM development.

When we look around and perform complex tasks, how we see and selectively process what we see is crucial. However, the lack of this visual search mechanism in current multimodal LLMs (MLLMs) hinders their ability to focus on important visual details, especially when handling high-resolution and visually crowded images. To address this, we introduce V*, an LLM-guided visual search mechanism that employs the world knowledge in LLMs for efficient visual querying. When combined with an MLLM, this mechanism enhances collaborative reasoning, contextual understanding, and precise targeting of specific visual elements. This integration results in a new MLLM meta-architecture, named Show, sEArch, and TelL (SEAL). We further create V*Bench, a benchmark specifically designed to evaluate MLLMs in their ability to process high-resolution images and focus on visual details. Our study highlights the necessity of incorporating visual search capabilities into multimodal systems. The code is available https://github.com/penghao-wu/vstar.

In this work, we provide a systematic survey of Discrete Diffusion Language Models (dLLMs) and Discrete Diffusion Multimodal Language Models (dMLLMs). Unlike autoregressive (AR) models, dLLMs and dMLLMs adopt a multi-token, parallel decoding paradigm using full attention and a denoising-based generation strategy. This paradigm naturally enables parallel generation, fine-grained output controllability, and dynamic, response-aware perception. These capabilities are previously difficult to achieve with AR models. Recently, a growing number of industrial-scale proprietary d(M)LLMs, as well as a large number of open-source academic d(M)LLMs, have demonstrated performance comparable to their autoregressive counterparts, while achieving up to 10x acceleration in inference speed. The advancement of discrete diffusion LLMs and MLLMs has been largely driven by progress in two domains. The first is the development of autoregressive LLMs and MLLMs, which has accumulated vast amounts of data, benchmarks, and foundational infrastructure for training and inference. The second contributing domain is the evolution of the mathematical models underlying discrete diffusion. Together, these advancements have catalyzed a surge in dLLMs and dMLLMs research in early 2025. In this work, we present a comprehensive overview of the research in the dLLM and dMLLM domains. We trace the historical development of dLLMs and dMLLMs, formalize the underlying mathematical frameworks, and categorize representative models. We further analyze key techniques for training and inference, and summarize emerging applications across language, vision-language, and biological domains. We conclude by discussing future directions for research and deployment. Paper collection: https://github.com/LiQiiiii/DLLM-Survey

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm. Although several multimodal reasoning models have been explored in the medical domain, most of them focus exclusively on basic reasoning, which refers to shallow inference based on visual feature matching. However, real-world clinical diagnosis extends beyond basic reasoning, demanding reasoning processes that integrate heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, the first ophthalmic multimodal dataset with the full spectrum of perception and reasoning. It encompasses both basic reasoning tasks and complex reasoning tasks, aiming to enhance visual-centric fundamental reasoning capabilities and emulate realistic clinical thinking patterns. Building upon MM-Retinal-Reason, we propose OphthaReason, the first ophthalmology-specific multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we specifically design a novel method called Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates the model's exploration depth using a shaped advantage mechanism. Comprehensive experiments demonstrate that our model achieves state-of-the-art performance on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 24.92\%, 15.00\%, 21.20\%, and 17.66\%. Project Page: https://github.com/lxirich/OphthaReason{link}.

Models such as GPT-4 and Med-PaLM 2 have demonstrated impressive performance on a wide variety of biomedical NLP tasks. However, these models have hundreds of billions of parameters, are computationally expensive to run, require users to send their input data over the internet, and are trained on unknown data sources. Can smaller, more targeted models compete? To address this question, we build and release BioMedLM, a 2.7 billion parameter GPT-style autoregressive model trained exclusively on PubMed abstracts and full articles. When fine-tuned, BioMedLM can produce strong multiple-choice biomedical question-answering results competitive with much larger models, such as achieving a score of 57.3% on MedMCQA (dev) and 69.0% on the MMLU Medical Genetics exam. BioMedLM can also be fine-tuned to produce useful answers to patient questions on medical topics. This demonstrates that smaller models can potentially serve as transparent, privacy-preserving, economical and environmentally friendly foundations for particular NLP applications, such as in biomedicine. The model is available on the Hugging Face Hub: https://huggingface.co/stanford-crfm/BioMedLM.

In recent years, multimodal large language models (MLLMs) have shown strong potential in real-world applications. They are developing rapidly due to their remarkable ability to comprehend multimodal information and their inherent powerful cognitive and reasoning capabilities. Among MLLMs, vision language models (VLM) stand out for their ability to understand vision information. However, the scaling trend of VLMs under the current mainstream paradigm has not been extensively studied. Whether we can achieve better performance by training even larger models is still unclear. To address this issue, we conducted experiments on the pretraining stage of MLLMs. We conduct our experiment using different encoder sizes and large language model (LLM) sizes. Our findings indicate that merely increasing the size of encoders does not necessarily enhance the performance of VLMs. Moreover, we analyzed the effects of LLM backbone parameter size and data quality on the pretraining outcomes. Additionally, we explored the differences in scaling laws between LLMs and VLMs.

The standard practice for developing contemporary MLLMs is to feed features from vision encoder(s) into the LLM and train with natural language supervision. In this work, we posit an overlooked opportunity to optimize the intermediate LLM representations through a vision perspective (objective), i.e., solely natural language supervision is sub-optimal for the MLLM's visual understanding ability. To that end, we propose OLA-VLM, the first approach distilling knowledge into the LLM's hidden representations from a set of target visual representations. Firstly, we formulate the objective during the pretraining stage in MLLMs as a coupled optimization of predictive visual embedding and next text-token prediction. Secondly, we investigate MLLMs trained solely with natural language supervision and identify a positive correlation between the quality of visual representations within these models and their downstream performance. Moreover, upon probing our OLA-VLM, we observe improved representation quality owing to the embedding optimization. Thirdly, we demonstrate that our OLA-VLM outperforms the single and multi-encoder baselines, proving our approach's superiority over explicitly feeding the corresponding features to the LLM. Particularly, OLA-VLM boosts performance by an average margin of up to 2.5% on various benchmarks, with a notable improvement of 8.7% on the Depth task in CV-Bench. Our code is open-sourced at https://github.com/SHI-Labs/OLA-VLM .

Multimodal large language models (MLLMs) have demonstrated impressive performance in various vision-language (VL) tasks, but their expensive computations still limit the real-world application. To address this issue, recent efforts aim to compress the visual features to save the computational costs of MLLMs. However, direct visual compression methods, e.g. efficient projectors, inevitably destroy the visual semantics in MLLM, especially in difficult samples. To overcome this shortcoming, we propose a novel dynamic pyramid network (DPN) for efficient MLLMs. Specifically, DPN formulates MLLM as a hierarchical structure where visual features are gradually compressed with increasing depth. In this case, even with a high compression ratio, fine-grained visual information can still be perceived in shallow layers. To maximize the benefit of DPN, we further propose an innovative Dynamic Pooling Experts (DPE) that can dynamically choose the optimal visual compression rate according to input features. With this design, harder samples will be assigned larger computations, thus preserving the model performance. To validate our approach, we conduct extensive experiments on two popular MLLMs and ten benchmarks. Experimental results show that DPN can save up to 56% average FLOPs on LLaVA while further achieving +0.74% performance gains. Besides, the generalization ability of DPN is also validated on the existing high-resolution MLLM called LLaVA-HR. Our source codes are anonymously released at https://github.com/aihao2000/DPN-LLaVA.

Multimodal Large Language Model (MLLMs) leverages Large Language Models as a cognitive framework for diverse visual-language tasks. Recent efforts have been made to equip MLLMs with visual perceiving and grounding capabilities. However, there still remains a gap in providing fine-grained pixel-level perceptions and extending interactions beyond text-specific inputs. In this work, we propose {AnyRef}, a general MLLM model that can generate pixel-wise object perceptions and natural language descriptions from multi-modality references, such as texts, boxes, images, or audio. This innovation empowers users with greater flexibility to engage with the model beyond textual and regional prompts, without modality-specific designs. Through our proposed refocusing mechanism, the generated grounding output is guided to better focus on the referenced object, implicitly incorporating additional pixel-level supervision. This simple modification utilizes attention scores generated during the inference of LLM, eliminating the need for extra computations while exhibiting performance enhancements in both grounding masks and referring expressions. With only publicly available training data, our model achieves state-of-the-art results across multiple benchmarks, including diverse modality referring segmentation and region-level referring expression generation.

Whole Slide Images (WSIs) exhibit hierarchical structure, where diagnostic information emerges from cellular morphology, regional tissue organization, and global context. Existing Computational Pathology (CPath) Multimodal Large Language Models (MLLMs) typically compress an entire WSI into a single embedding, which hinders fine-grained grounding and ignores how pathologists synthesize evidence across different scales. We introduce MLLM-HWSI, a Hierarchical WSI-level MLLM that aligns visual features with pathology language at four distinct scales, cell as word, patch as phrase, region as sentence, and WSI as paragraph to support interpretable evidence-grounded reasoning. MLLM-HWSI decomposes each WSI into multi-scale embeddings with scale-specific projectors and jointly enforces (i) a hierarchical contrastive objective and (ii) a cross-scale consistency loss, preserving semantic coherence from cells to the WSI. We compute diagnostically relevant patches and aggregate segmented cell embeddings into a compact cellular token per-patch using a lightweight Cell-Cell Attention Fusion (CCAF) transformer. The projected multi-scale tokens are fused with text tokens and fed to an instruction-tuned LLM for open-ended reasoning, VQA, report, and caption generation tasks. Trained in three stages, MLLM-HWSI achieves new SOTA results on 13 WSI-level benchmarks across six CPath tasks. By aligning language with multi-scale visual evidence, MLLM-HWSI provides accurate, interpretable outputs that mirror diagnostic workflows and advance holistic WSI understanding. Code is available at: https://github.com/BasitAlawode/HWSI-MLLM{GitHub}.

The rapid evolution of Multimodal Large Language Models (MLLMs) has brought substantial advancements in artificial intelligence, significantly enhancing the capability to understand and generate multimodal content. While prior studies have largely concentrated on model architectures and training methodologies, a thorough analysis of the benchmarks used for evaluating these models remains underexplored. This survey addresses this gap by systematically reviewing 211 benchmarks that assess MLLMs across four core domains: understanding, reasoning, generation, and application. We provide a detailed analysis of task designs, evaluation metrics, and dataset constructions, across diverse modalities. We hope that this survey will contribute to the ongoing advancement of MLLM research by offering a comprehensive overview of benchmarking practices and identifying promising directions for future work. An associated GitHub repository collecting the latest papers is available.

In the past year, Multimodal Large Language Models (MLLMs) have demonstrated remarkable performance in tasks such as visual question answering, visual understanding and reasoning. However, the extensive model size and high training and inference costs have hindered the widespread application of MLLMs in academia and industry. Thus, studying efficient and lightweight MLLMs has enormous potential, especially in edge computing scenarios. In this survey, we provide a comprehensive and systematic review of the current state of efficient MLLMs. Specifically, we summarize the timeline of representative efficient MLLMs, research state of efficient structures and strategies, and the applications. Finally, we discuss the limitations of current efficient MLLM research and promising future directions. Please refer to our GitHub repository for more details: https://github.com/lijiannuist/Efficient-Multimodal-LLMs-Survey.

Landmark detection plays a crucial role in medical imaging tasks that rely on precise spatial localization, including specific applications in diagnosis, treatment planning, image registration, and surgical navigation. However, manual annotation is labor-intensive and requires expert knowledge. While deep learning shows promise in automating this task, progress is hindered by limited public datasets, inconsistent benchmarks, and non-standardized baselines, restricting reproducibility, fair comparisons, and model generalizability. This work introduces nnLandmark, a self-configuring deep learning framework for 3D medical landmark detection, adapting nnU-Net to perform heatmap-based regression. By leveraging nnU-Net's automated configuration, nnLandmark eliminates the need for manual parameter tuning, offering out-of-the-box usability. It achieves state-of-the-art accuracy across two public datasets, with a mean radial error (MRE) of 1.5 mm on the Mandibular Molar Landmark (MML) dental CT dataset and 1.2 mm for anatomical fiducials on a brain MRI dataset (AFIDs), where nnLandmark aligns with the inter-rater variability of 1.5 mm. With its strong generalization, reproducibility, and ease of deployment, nnLandmark establishes a reliable baseline for 3D landmark detection, supporting research in anatomical localization and clinical workflows that depend on precise landmark identification. The code will be available soon.

The increasing interest in developing Artificial Intelligence applications in the medical domain, suffers from the lack of high-quality dataset, mainly due to privacy-related issues. Moreover, the recent rising of Multimodal Large Language Models (MLLM) leads to a need for multimodal medical datasets, where clinical reports and findings are attached to the corresponding CT or MR scans. This paper illustrates the entire workflow for building the data set MedPix 2.0. Starting from the well-known multimodal dataset MedPix\textregistered, mainly used by physicians, nurses and healthcare students for Continuing Medical Education purposes, a semi-automatic pipeline was developed to extract visual and textual data followed by a manual curing procedure where noisy samples were removed, thus creating a MongoDB database. Along with the dataset, we developed a GUI aimed at navigating efficiently the MongoDB instance, and obtaining the raw data that can be easily used for training and/or fine-tuning MLLMs. To enforce this point, we also propose a CLIP-based model trained on MedPix 2.0 for scan classification tasks.

Multilingual large language models (MLLMs) have shown impressive capabilities across a variety of languages. However, efficacy can differ greatly between different language families, especially for those with limited linguistic resources. This report presents MERaLiON-TextLLM, a series of open-source language models specifically tailored to improve understanding and generation in Chinese, Indonesian, Malay, and Singlish. The initial released model is built on Llama-3-8B-Base and refined through a meticulously crafted process of continued pre-training and weight merging. Our approach achieves performance improvements across benchmarks in these languages, exceeding the capabilities of the official Llama-3 models. We provide the model checkpoints as a resource to support further research and development in cross-lingual language understanding.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

Multimodal Large Language Models (MLLMs) are commonly derived by extending pre-trained Large Language Models (LLMs) with visual capabilities. In this work, we investigate how MLLMs process visual inputs by analyzing their attention mechanisms. We reveal a surprising sparsity phenomenon: only a small subset (approximately less than 5%) of attention heads in LLMs actively contribute to visual understanding, termed visual heads. To identify these heads efficiently, we design a training-free framework that quantifies head-level visual relevance through targeted response analysis. Building on this discovery, we introduce SparseMM, a KV-Cache optimization strategy that allocates asymmetric computation budgets to heads in LLMs based on their visual scores, leveraging the sparity of visual heads for accelerating the inference of MLLMs. Compared with prior KV-Cache acceleration methods that ignore the particularity of visual, SparseMM prioritizes stress and retaining visual semantics during decoding. Extensive evaluations across mainstream multimodal benchmarks demonstrate that SparseMM achieves superior accuracy-efficiency trade-offs. Notably, SparseMM delivers 1.38x real-time acceleration and 52% memory reduction during generation while maintaining performance parity on efficiency test. Our project is open sourced at https://github.com/CR400AF-A/SparseMM.

The ability to accurately interpret complex visual information is a crucial topic of multimodal large language models (MLLMs). Recent work indicates that enhanced visual perception significantly reduces hallucinations and improves performance on resolution-sensitive tasks, such as optical character recognition and document analysis. A number of recent MLLMs achieve this goal using a mixture of vision encoders. Despite their success, there is a lack of systematic comparisons and detailed ablation studies addressing critical aspects, such as expert selection and the integration of multiple vision experts. This study provides an extensive exploration of the design space for MLLMs using a mixture of vision encoders and resolutions. Our findings reveal several underlying principles common to various existing strategies, leading to a streamlined yet effective design approach. We discover that simply concatenating visual tokens from a set of complementary vision encoders is as effective as more complex mixing architectures or strategies. We additionally introduce Pre-Alignment to bridge the gap between vision-focused encoders and language tokens, enhancing model coherence. The resulting family of MLLMs, Eagle, surpasses other leading open-source models on major MLLM benchmarks. Models and code: https://github.com/NVlabs/Eagle

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Surgical site infection (SSI) is one of the most common and costly healthcare-associated infections and and surgical wound care remains a significant clinical challenge in preventing SSIs and improving patient outcomes. While recent studies have explored the use of deep learning for preliminary surgical wound screening, progress has been hindered by concerns over data privacy and the high costs associated with expert annotation. Currently, no publicly available dataset or benchmark encompasses various types of surgical wounds, resulting in the absence of an open-source Surgical-Wound screening tool. To address this gap: (1) we present SurgWound, the first open-source dataset featuring a diverse array of surgical wound types. It contains 697 surgical wound images annotated by 3 professional surgeons with eight fine-grained clinical attributes. (2) Based on SurgWound, we introduce the first benchmark for surgical wound diagnosis, which includes visual question answering (VQA) and report generation tasks to comprehensively evaluate model performance. (3) Furthermore, we propose a three-stage learning framework, WoundQwen, for surgical wound diagnosis. In the first stage, we employ five independent MLLMs to accurately predict specific surgical wound characteristics. In the second stage, these predictions serve as additional knowledge inputs to two MLLMs responsible for diagnosing outcomes, which assess infection risk and guide subsequent interventions. In the third stage, we train a MLLM that integrates the diagnostic results from the previous two stages to produce a comprehensive report. This three-stage framework can analyze detailed surgical wound characteristics and provide subsequent instructions to patients based on surgical images, paving the way for personalized wound care, timely intervention, and improved patient outcomes.

Multimodal Large Language Models (MLLMs) have recently gained immense popularity. Powerful commercial models like ChatGPT-4V and Gemini, as well as open-source ones such as LLaVA, are essentially general-purpose models and are applied to solve a wide variety of tasks, including those in computer vision. These neural networks possess such strong general knowledge and reasoning abilities that they have proven capable of working even on tasks for which they were not specifically trained. We compared the capabilities of the most powerful MLLMs to date: ShareGPT4V, ChatGPT, LLaVA-Next in a specialized task of age and gender estimation with our state-of-the-art specialized model, MiVOLO. We also updated MiVOLO and provide details and new metrics in this article. This comparison has yielded some interesting results and insights about the strengths and weaknesses of the participating models. Furthermore, we attempted various ways to fine-tune the ShareGPT4V model for this specific task, aiming to achieve state-of-the-art results in this particular challenge. Although such a model would not be practical in production, as it is incredibly expensive compared to a specialized model like MiVOLO, it could be very useful in some tasks, like data annotation.

Multi-modal Large Language Models (MLLMs) are gaining significant attention for their ability to process multi-modal data, providing enhanced contextual understanding of complex problems. MLLMs have demonstrated exceptional capabilities in tasks such as Visual Question Answering (VQA); however, they often struggle with fundamental engineering problems, and there is a scarcity of specialized datasets for training on topics like digital electronics. To address this gap, we propose a benchmark dataset called ElectroVizQA specifically designed to evaluate MLLMs' performance on digital electronic circuit problems commonly found in undergraduate curricula. This dataset, the first of its kind tailored for the VQA task in digital electronics, comprises approximately 626 visual questions, offering a comprehensive overview of digital electronics topics. This paper rigorously assesses the extent to which MLLMs can understand and solve digital electronic circuit questions, providing insights into their capabilities and limitations within this specialized domain. By introducing this benchmark dataset, we aim to motivate further research and development in the application of MLLMs to engineering education, ultimately bridging the performance gap and enhancing the efficacy of these models in technical fields.

Multimodal in-context learning (ICL) remains underexplored despite significant potential for domains such as medicine. Clinicians routinely encounter diverse, specialized tasks requiring adaptation from limited examples, such as drawing insights from a few relevant prior cases or considering a constrained set of differential diagnoses. While multimodal large language models (MLLMs) have shown advances in medical visual question answering (VQA), their ability to learn multimodal tasks from context is largely unknown. We introduce SMMILE, the first expert-driven multimodal ICL benchmark for medical tasks. Eleven medical experts curated problems, each including a multimodal query and multimodal in-context examples as task demonstrations. SMMILE encompasses 111 problems (517 question-image-answer triplets) covering 6 medical specialties and 13 imaging modalities. We further introduce SMMILE++, an augmented variant with 1038 permuted problems. A comprehensive evaluation of 15 MLLMs demonstrates that most models exhibit moderate to poor multimodal ICL ability in medical tasks. In open-ended evaluations, ICL contributes only 8% average improvement over zero-shot on SMMILE and 9.4% on SMMILE++. We observe a susceptibility for irrelevant in-context examples: even a single noisy or irrelevant example can degrade performance by up to 9.5%. Moreover, example ordering exhibits a recency bias, i.e., placing the most relevant example last can lead to substantial performance improvements by up to 71%. Our findings highlight critical limitations and biases in current MLLMs when learning multimodal medical tasks from context.

Recent advances in reasoning-enhanced large language models (LLMs) and multimodal LLMs (MLLMs) have significantly improved performance in complex tasks, yet medical AI models often overlook the structured reasoning processes inherent in clinical practice. In this work, we present ChestX-Reasoner, a radiology diagnosis MLLM designed to leverage process supervision mined directly from clinical reports, reflecting the step-by-step reasoning followed by radiologists. We construct a large dataset by extracting and refining reasoning chains from routine radiology reports. Our two-stage training framework combines supervised fine-tuning and reinforcement learning guided by process rewards to better align model reasoning with clinical standards. We introduce RadRBench-CXR, a comprehensive benchmark featuring 59K visual question answering samples with 301K clinically validated reasoning steps, and propose RadRScore, a metric evaluating reasoning factuality, completeness, and effectiveness. ChestX-Reasoner outperforms existing medical and general-domain MLLMs in both diagnostic accuracy and reasoning ability, achieving 16%, 5.9%, and 18% improvements in reasoning ability compared to the best medical MLLM, the best general MLLM, and its base model, respectively, as well as 3.3%, 24%, and 27% improvements in outcome accuracy. All resources are open-sourced to facilitate further research in medical reasoning MLLMs.

Multi-modal large language models (MLLMs) have demonstrated remarkable vision-language capabilities, primarily due to the exceptional in-context understanding and multi-task learning strengths of large language models (LLMs). The advent of visual instruction tuning has further enhanced MLLMs' performance in vision-language understanding. However, while existing MLLMs adeptly recognize what objects are in an image, they still face challenges in effectively discerning where these objects are, particularly along the distance (scene depth) axis. To overcome this limitation in MLLMs, we introduce Proximity Question Answering (Proximity QA), a novel framework designed to enable MLLMs to infer the proximity relationship between objects in images. The framework operates in two phases: the first phase focuses on guiding the models to understand the relative depth of objects, and the second phase further encourages the models to infer the proximity relationships between objects based on their depth perceptions. We also propose a VQA dataset called Proximity-110K, containing additional instructions that incorporate depth information and the proximity relationships of objects. We have conducted extensive experiments to validate Proximity QA's superior ability in depth perception and proximity analysis, outperforming other state-of-the-art MLLMs. Code and dataset will be released at magenta{https://github.com/NorthSummer/ProximityQA.git}.

Recent advances in large language models have catalyzed the development of multimodal LLMs (MLLMs) that integrate text, speech, and vision within unified frameworks. As MLLMs evolve from narrow, monolingual, task-specific systems to general-purpose instruction-following models, a key frontier lies in evaluating their multilingual and multimodal capabilities over both long and short contexts. However, existing benchmarks fall short in evaluating these dimensions jointly: they are often limited to English, mostly focus on one single modality at a time, rely on short-form contexts, or lack human annotations -- hindering comprehensive assessment of model performance across languages, modalities, and task complexity. To address these gaps, we introduce MCIF (Multimodal Crosslingual Instruction Following), the first multilingual human-annotated benchmark based on scientific talks that is designed to evaluate instruction-following in crosslingual, multimodal settings over both short- and long-form inputs. MCIF spans three core modalities -- speech, vision, and text -- and four diverse languages (English, German, Italian, and Chinese), enabling a comprehensive evaluation of MLLMs' abilities to interpret instructions across languages and combine them with multimodal contextual information. MCIF is released under a CC-BY 4.0 license to encourage open research and progress in MLLMs development.

We propose SPHINX-X, an extensive Multimodality Large Language Model (MLLM) series developed upon SPHINX. To improve the architecture and training efficiency, we modify the SPHINX framework by removing redundant visual encoders, bypassing fully-padded sub-images with skip tokens, and simplifying multi-stage training into a one-stage all-in-one paradigm. To fully unleash the potential of MLLMs, we assemble a comprehensive multi-domain and multimodal dataset covering publicly available resources in language, vision, and vision-language tasks. We further enrich this collection with our curated OCR intensive and Set-of-Mark datasets, extending the diversity and generality. By training over different base LLMs including TinyLlama1.1B, InternLM2-7B, LLaMA2-13B, and Mixtral8x7B, we obtain a spectrum of MLLMs that vary in parameter size and multilingual capabilities. Comprehensive benchmarking reveals a strong correlation between the multi-modal performance with the data and parameter scales. Code and models are released at https://github.com/Alpha-VLLM/LLaMA2-Accessory

Multimodal large language models (MLLMs) have broadened the scope of AI applications. Existing automatic evaluation methodologies for MLLMs are mainly limited in evaluating queries without considering user experiences, inadequately addressing the nuances of creative and associative multimodal tasks. However, the open-ended and subjective nature of such tasks poses a significant challenge to the evaluation methodology, where it is difficult to define the ground-truth answers for them. To this end, in our paper, we propose a new evaluation paradigm for MLLMs, which is evaluating MLLMs with per-sample criteria using potent MLLM as the judge. To validate the feasibility and effectiveness of this paradigm, we design a benchmark, dubbed MLLM-Bench, by curating the evaluation samples across six comprehensive cognitive levels. We benchmark 21 popular MLLMs in a pairwise-comparison fashion, showing diverse performance across models. Moreover, the validity of our benchmark manifests itself in reaching 88.02% agreement with human evaluation. We contend that the proposed paradigm explores the potential of MLLMs as effective evaluation tools with the help of per-sample criteria. See online leaderboard at https://mllm-bench.llmzoo.com.

Multimodal Large Language Models (MLLMs) have shown immense promise in universal multimodal retrieval, which aims to find relevant items of various modalities for a given query. But their practical application is often hindered by the substantial computational cost incurred from processing a large number of tokens from visual inputs. In this paper, we propose Magic-MM-Embedding, a series of novel models that achieve both high efficiency and state-of-the-art performance in universal multimodal embedding. Our approach is built on two synergistic pillars: (1) a highly efficient MLLM architecture incorporating visual token compression to drastically reduce inference latency and memory footprint, and (2) a multi-stage progressive training strategy designed to not only recover but significantly boost performance. This coarse-to-fine training paradigm begins with extensive continue pretraining to restore multimodal understanding and generation capabilities, progresses to large-scale contrastive pretraining and hard negative mining to enhance discriminative power, and culminates in a task-aware fine-tuning stage guided by an MLLM-as-a-Judge for precise data curation. Comprehensive experiments show that our model outperforms existing methods by a large margin while being more inference-efficient.

Multimodal Large Language Models (MLLMs) have shown promise in a broad range of vision-language tasks with their strong reasoning and generalization capabilities. However, they heavily depend on high-quality data in the Supervised Fine-Tuning (SFT) phase. The existing approaches aim to curate high-quality data via GPT-4V, but they are not scalable due to the commercial nature of GPT-4V and the simplicity of the prompts used to instruct the model. To this end, we devised the FullAnno system, which is a data engine that can generate large-scale, high-quality, and fine-grained image annotations consisting of the category and position of objects, region descriptions, text information, as well as image dense captions. This engine is characterized by its cascade annotation process, which involves multiple expert models and employs rich prompts to instruct LLMs in generating dense image captions. We re-annotated the COCO and Visual Genome datasets using our FullAnno system, tripling the number of object annotations and increasing the length of the original image captions by a factor of 15. Experiments show that the regenerated annotation can significantly enhance the capabilities of LLaVA-v1.5 on several benchmarks. The re-annotated data are available at: https://arcana-project-page.github.io

Multimodal large language models (MLLMs) have shown impressive capabilities across various domains, excelling in processing and understanding information from multiple modalities. Despite the rapid progress made previously, insufficient OCR ability hinders MLLMs from excelling in text-related tasks. In this paper, we present Ocean-OCR, a 3B MLLM with state-of-the-art performance on various OCR scenarios and comparable understanding ability on general tasks. We employ Native Resolution ViT to enable variable resolution input and utilize a substantial collection of high-quality OCR datasets to enhance the model performance. We demonstrate the superiority of Ocean-OCR through comprehensive experiments on open-source OCR benchmarks and across various OCR scenarios. These scenarios encompass document understanding, scene text recognition, and handwritten recognition, highlighting the robust OCR capabilities of Ocean-OCR. Note that Ocean-OCR is the first MLLM to outperform professional OCR models such as TextIn and PaddleOCR.

Recent studies have demonstrated Large Language Models (LLMs) can extend their zero-shot generalization capabilities to multimodal learning through instruction tuning. As more modalities and downstream tasks are introduced, negative conflicts and interference may have a worse impact on performance. While this phenomenon has been overlooked in previous work, we propose a novel and extensible framework, called Octavius, for comprehensive studies and experimentation on multimodal learning with Multimodal Large Language Models (MLLMs). Specifically, we combine the well-known Mixture-of-Experts (MoE) and one of the representative PEFT techniques, i.e., LoRA, designing a novel LLM-based decoder, called LoRA-MoE, for multimodal learning. To the best of our knowledge, we are one of the pioneering efforts to introduce MoE into MLLMs to address this problem. The experimental results (about 20% improvement) have shown the effectiveness and versatility of our design in various 2D and 3D downstream tasks. Code and datasets are available at https://openlamm.github.io/paper_list/Octavius.

We present Singpath-VL, a vision-language large model, to fill the vacancy of AI assistant in cervical cytology. Recent advances in multi-modal large language models (MLLMs) have significantly propelled the field of computational pathology. However, their application in cytopathology, particularly cervical cytology, remains underexplored, primarily due to the scarcity of large-scale, high-quality annotated datasets. To bridge this gap, we first develop a novel three-stage pipeline to synthesize a million-scale image-description dataset. The pipeline leverages multiple general-purpose MLLMs as weak annotators, refines their outputs through consensus fusion and expert knowledge injection, and produces high-fidelity descriptions of cell morphology. Using this dataset, we then fine-tune the Qwen3-VL-4B model via a multi-stage strategy to create a specialized cytopathology MLLM. The resulting model, named Singpath-VL, demonstrates superior performance in fine-grained morphological perception and cell-level diagnostic classification. To advance the field, we will open-source a portion of the synthetic dataset and benchmark.

The rapid advancement of Large Language Models (LLMs) has led to an influx of efforts to extend their capabilities to multimodal tasks. Among them, growing attention has been focused on monolithic Multimodal Large Language Models (MLLMs) that integrate visual encoding and language decoding into a single LLM. Despite the structural simplicity and deployment-friendliness, training a monolithic MLLM with promising performance still remains challenging. In particular, the popular approaches adopt continuous pre-training to extend a pre-trained LLM to a monolithic MLLM, which suffers from catastrophic forgetting and leads to performance degeneration. In this paper, we aim to overcome this limitation from the perspective of delta tuning. Specifically, our core idea is to embed visual parameters into a pre-trained LLM, thereby incrementally learning visual knowledge from massive data via delta tuning, i.e., freezing the LLM when optimizing the visual parameters. Based on this principle, we present Mono-InternVL, a novel monolithic MLLM that seamlessly integrates a set of visual experts via a multimodal mixture-of-experts structure. Moreover, we propose an innovative pre-training strategy to maximize the visual capability of Mono-InternVL, namely Endogenous Visual Pre-training (EViP). In particular, EViP is designed as a progressive learning process for visual experts, which aims to fully exploit the visual knowledge from noisy data to high-quality data. To validate our approach, we conduct extensive experiments on 16 benchmarks. Experimental results not only validate the superior performance of Mono-InternVL compared to the state-of-the-art MLLM on 6 multimodal benchmarks, e.g., +113 points over InternVL-1.5 on OCRBench, but also confirm its better deployment efficiency, with first token latency reduced by up to 67%.

As a prominent direction of Artificial General Intelligence (AGI), Multimodal Large Language Models (MLLMs) have garnered increased attention from both industry and academia. Building upon pre-trained LLMs, this family of models further develops multimodal perception and reasoning capabilities that are impressive, such as writing code given a flow chart or creating stories based on an image. In the development process, evaluation is critical since it provides intuitive feedback and guidance on improving models. Distinct from the traditional train-eval-test paradigm that only favors a single task like image classification, the versatility of MLLMs has spurred the rise of various new benchmarks and evaluation methods. In this paper, we aim to present a comprehensive survey of MLLM evaluation, discussing four key aspects: 1) the summarised benchmarks types divided by the evaluation capabilities, including foundation capabilities, model self-analysis, and extented applications; 2) the typical process of benchmark counstruction, consisting of data collection, annotation, and precautions; 3) the systematic evaluation manner composed of judge, metric, and toolkit; 4) the outlook for the next benchmark. This work aims to offer researchers an easy grasp of how to effectively evaluate MLLMs according to different needs and to inspire better evaluation methods, thereby driving the progress of MLLM research.

Multimodal Large Language Models (MLLMs) excel at simple vision-language tasks but struggle when faced with complex tasks that require multiple capabilities, such as simultaneously recognizing objects, counting them, and understanding their spatial relationships. This might be partially the result of the fact that Visual Instruction Tuning (VIT), a critical training step for MLLMs, has traditionally focused on scaling data volume, but not the compositional complexity of training examples. We propose COMPACT (COMPositional Atomic-to-complex visual Capability Tuning), which generates a training dataset explicitly controlling for the compositional complexity of the training examples. The data from COMPACT allows MLLMs to train on combinations of atomic capabilities to learn complex capabilities more efficiently. Across all benchmarks, COMPACT achieves comparable performance to the LLaVA-665k VIT while using less than 10% of its data budget, and even outperforms it on several, especially those involving complex multi-capability tasks. For example, COMPACT achieves substantial 83.3% improvement on MMStar and 94.0% improvement on MM-Vet compared to the full-scale VIT on particularly complex questions that require four or more atomic capabilities. COMPACT offers a scalable, data-efficient, visual compositional tuning recipe to improve on complex visual-language tasks.

Recently, multimodal large language models (MLLMs) have received much attention for their impressive capabilities. The evaluation of MLLMs is becoming critical to analyzing attributes of MLLMs and providing valuable insights. However, current benchmarks overlook the problem of prompt sensitivity - minor prompt variations may lead to significant performance fluctuations. Thus, inappropriate prompts may obscure the models' capabilities, underestimating the models' performance. Moreover, different models have different preferences for different prompts, and thus, using the same prompt for all models will cause evaluation bias. This paper analyzes this deficiency in existing benchmarks and further introduces a new evaluation framework named TP-Eval, which introduces a prompt customization method to reduce evaluation biases and tap models' potential. TP-Eval will rewrite the original prompts to different customized prompts for different models. In particular, we propose some well-designed modules for prompt customization tailored to the scenario of MLLM evaluation. Extensive experiments demonstrate the effectiveness of our approach to uncovering models' capabilities, and TP-Eval should benefit the community in developing more comprehensive and convincing MLLM evaluation benchmarks.

Despite the great advance of Multimodal Large Language Models (MLLMs) in both instruction dataset building and benchmarking, the independence of training and evaluation makes current MLLMs hard to further improve their capability under the guidance of evaluation results with a relatively low human cost. In this paper, we propose MLLM-DataEngine, a novel closed-loop system that bridges data generation, model training, and evaluation. Within each loop iteration, the MLLM-DataEngine first analyze the weakness of the model based on the evaluation results, then generate a proper incremental dataset for the next training iteration and enhance the model capability iteratively. Compared with previous data collection methods which are separate from the benchmarking, the data generated by MLLM-DataEngine shows better targeting, quality, and correctness. For targeting, we propose an Adaptive Bad-case Sampling module, which adjusts the ratio of different types of data within each incremental dataset based on the benchmarking results. For quality, we resort to GPT-4 to generate high-quality data with each given data type. For correctness, prompt design is critical for the data generation results. Rather than previous hand-crafted prompt, we propose an Interactive Prompt Optimization strategy, which optimizes the prompt with the multi-round interaction between human and GPT, and improve the correctness of generated data greatly. Through extensive experiments, we find our MLLM-DataEngine could boost the MLLM capability in a targeted and automatic manner, with only a few human participation. We hope it could be a general solution for the following MLLMs building. The MLLM-DataEngine has been open-sourced and is now available at https://github.com/opendatalab/MLLM-DataEngine.

Multimodal Large Language Models (MLLMs) have made significant advancements, demonstrating powerful capabilities in processing and understanding multimodal data. Fine-tuning MLLMs with Federated Learning (FL) allows for expanding the training data scope by including private data sources, thereby enhancing their practical applicability in privacy-sensitive domains. However, current research remains in the early stage, particularly in addressing the multimodal heterogeneities in real-world applications. In this paper, we introduce a benchmark to evaluate the performance of federated fine-tuning of MLLMs across various multimodal heterogeneous scenarios, laying the groundwork for future research in the field. Our benchmark includes two lightweight MLLMs, two downstream tasks, three evaluation metrics, and five datasets across three domains, along with six comparison baselines, covering over ten types of modality heterogeneities across four multimodal scenarios. To address the challenges posed by multimodal heterogeneity, we develop a general FedMLLM framework that integrates classic FL methods alongside two modality-agnostic strategies. Extensive experimental results show that our proposed FL paradigm improves the performance of MLLMs by broadening the range of training data and mitigating multimodal heterogeneity. Code is available in supplementary materials.

In the realm of multimodal research, numerous studies leverage substantial image-text pairs to conduct modal alignment learning, transforming Large Language Models (LLMs) into Multimodal LLMs and excelling in a variety of visual-language tasks. The prevailing methodologies primarily fall into two categories: self-attention-based and cross-attention-based methods. While self-attention-based methods offer superior data efficiency due to their simple MLP architecture, they often suffer from lower computational efficiency due to concatenating visual and textual tokens as input for LLM. Conversely, cross-attention-based methods, although less data-efficient due to additional learnable parameters, exhibit higher computational efficiency by avoiding long sequence input for LLM. To address these trade-offs, we introduce the Data-Efficient and Compute-Efficient Multimodal Large Language Model (EE-MLLM). Without introducing additional modules or learnable parameters, EE-MLLM achieves both data and compute efficiency. Specifically, we modify the original self-attention mechanism in MLLM to a composite attention mechanism. This mechanism has two key characteristics: 1) Eliminating the computational overhead of self-attention within visual tokens to achieve compute efficiency, and 2) Reusing the weights on each layer of LLM to facilitate effective modality alignment between vision and language for data efficiency. Experimental results demonstrate the effectiveness of EE-MLLM across a range of benchmarks, including general-purpose datasets like MMBench and SeedBench, as well as fine-grained tasks such as TextVQA and DocVQA.

The security of biomedical Multimodal Large Language Models (MLLMs) has attracted increasing attention. However, training samples easily contain private information and incorrect knowledge that are difficult to detect, potentially leading to privacy leakage or erroneous outputs after deployment. An intuitive idea is to reprocess the training set to remove unwanted content and retrain the model from scratch. Yet, this is impractical due to significant computational costs, especially for large language models. Machine unlearning has emerged as a solution to this problem, which avoids complete retraining by selectively removing undesired knowledge derived from harmful samples while preserving required capabilities on normal cases. However, there exist no available datasets to evaluate the unlearning quality for security protection in biomedical MLLMs. To bridge this gap, we propose the first benchmark Multimodal Large Language Model Unlearning for BioMedicine (MLLMU-Med) built upon our novel data generation pipeline that effectively integrates synthetic private data and factual errors into the training set. Our benchmark targets two key scenarios: 1) Privacy protection, where patient private information is mistakenly included in the training set, causing models to unintentionally respond with private data during inference; and 2) Incorrectness removal, where wrong knowledge derived from unreliable sources is embedded into the dataset, leading to unsafe model responses. Moreover, we propose a novel Unlearning Efficiency Score that directly reflects the overall unlearning performance across different subsets. We evaluate five unlearning approaches on MLLMU-Med and find that these methods show limited effectiveness in removing harmful knowledge from biomedical MLLMs, indicating significant room for improvement. This work establishes a new pathway for further research in this promising field.

Strong Artificial Intelligence (Strong AI) or Artificial General Intelligence (AGI) with abstract reasoning ability is the goal of next-generation AI. Recent advancements in Large Language Models (LLMs), along with the emerging field of Multimodal Large Language Models (MLLMs), have demonstrated impressive capabilities across a wide range of multimodal tasks and applications. Particularly, various MLLMs, each with distinct model architectures, training data, and training stages, have been evaluated across a broad range of MLLM benchmarks. These studies have, to varying degrees, revealed different aspects of the current capabilities of MLLMs. However, the reasoning abilities of MLLMs have not been systematically investigated. In this survey, we comprehensively review the existing evaluation protocols of multimodal reasoning, categorize and illustrate the frontiers of MLLMs, introduce recent trends in applications of MLLMs on reasoning-intensive tasks, and finally discuss current practices and future directions. We believe our survey establishes a solid base and sheds light on this important topic, multimodal reasoning.

Multimodal large language models (MLLMs) have achieved remarkable success across a broad range of vision tasks. However, constrained by the capacity of their internal world knowledge, prior work has proposed augmenting MLLMs by ``reasoning-then-tool-call'' for visual and textual search engines to obtain substantial gains on tasks requiring extensive factual information. However, these approaches typically define multimodal search in a naive setting, assuming that a single full-level or entity-level image query and few text query suffices to retrieve the key evidence needed to answer the question, which is unrealistic in real-world scenarios with substantial visual noise. Moreover, they are often limited in the reasoning depth and search breadth, making it difficult to solve complex questions that require aggregating evidence from diverse visual and textual sources. Building on this, we propose Vision-DeepResearch, which proposes one new multimodal deep-research paradigm, i.e., performs multi-turn, multi-entity and multi-scale visual and textual search to robustly hit real-world search engines under heavy noise. Our Vision-DeepResearch supports dozens of reasoning steps and hundreds of engine interactions, while internalizing deep-research capabilities into the MLLM via cold-start supervision and RL training, resulting in a strong end-to-end multimodal deep-research MLLM. It substantially outperforming existing multimodal deep-research MLLMs, and workflows built on strong closed-source foundation model such as GPT-5, Gemini-2.5-pro and Claude-4-Sonnet. The code will be released in https://github.com/Osilly/Vision-DeepResearch.

Conventional evaluation methods for multimodal LLMs (MLLMs) lack interpretability and are often insufficient to fully disclose significant capability gaps across models. To address this, we introduce AuditDM, an automated framework that actively discovers and rectifies MLLM failure modes by auditing their divergence. AuditDM fine-tunes an MLLM as an auditor via reinforcement learning to generate challenging questions and counterfactual images that maximize disagreement among target models. Once trained, the auditor uncovers diverse, interpretable exemplars that reveal model weaknesses and serve as annotation-free data for rectification. When applied to SoTA models like Gemma-3 and PaliGemma-2, AuditDM discovers more than 20 distinct failure types. Fine-tuning on these discoveries consistently improves all models across 16 benchmarks, and enables a 3B model to surpass its 28B counterpart. Our results suggest that as data scaling hits diminishing returns, targeted model auditing offers an effective path to model diagnosis and improvement.

The potential of Multimodal Large Language Models (MLLMs) in domain of medical imaging raise the demands of systematic and rigorous evaluation frameworks that are aligned with the real-world medical imaging practice. Existing practices that report single or coarse-grained metrics are lack the granularity required for specialized clinical support and fail to assess the reliability of reasoning mechanisms. To address this, we propose a paradigm shift toward multidimensional, fine-grained and in-depth evaluation. Based on a two-stage systematic construction pipeline designed for this paradigm, we instantiate it with MedRCube. We benchmark 33 MLLMs, Lingshu-32B achieve top-tier performance. Crucially, MedRCube exposes a series of pronounced insights inaccessible under prior evaluation settings. Furthermore, we introduce a credibility evaluation subset to quantify reasoning credibility, uncover a highly significant positive association between shortcut behavior and diagnostic task performance, raising concerns for clinically trustworthy deployment. The resources of this work can be found at https://github.com/F1mc/MedRCube.

Root canal (RC) treatment is a highly delicate and technically complex procedure in clinical practice, heavily influenced by the clinicians' experience and subjective judgment. Deep learning has made significant advancements in the field of computer-aided diagnosis (CAD) because it can provide more objective and accurate diagnostic results. However, its application in RC treatment is still relatively rare, mainly due to the lack of public datasets in this field. To address this issue, in this paper, we established a First Molar Root Canal segmentation dataset called FMRC-2025. Additionally, to alleviate the workload of manual annotation for dentists and fully leverage the unlabeled data, we designed a Cross-Frequency Collaborative training semi-supervised learning (SSL) Network called CFC-Net. It consists of two components: (1) Cross-Frequency Collaborative Mean Teacher (CFC-MT), which introduces two specialized students (SS) and one comprehensive teacher (CT) for collaborative multi-frequency training. The CT and SS are trained on different frequency components while fully integrating multi-frequency knowledge through cross and full frequency consistency supervisions. (2) Uncertainty-guided Cross-Frequency Mix (UCF-Mix) mechanism enables the network to generate high-confidence pseudo-labels while learning to integrate multi-frequency information and maintaining the structural integrity of the targets. Extensive experiments on FMRC-2025 and three public dental datasets demonstrate that CFC-MT is effective for RC segmentation and can also exhibit strong generalizability on other dental segmentation tasks, outperforming state-of-the-art SSL medical image segmentation methods. Codes and dataset will be released.

Large Language Models (LLMs) and Multimodal Large Language Models (MLLMs) have made significant advancements in reasoning capabilities. However, they still face challenges such as high computational demands and privacy concerns. This paper focuses on developing efficient Small Language Models (SLMs) and Multimodal Small Language Models (MSLMs) that retain competitive reasoning abilities. We introduce a novel training pipeline that enhances reasoning capabilities and facilitates deployment on edge devices, achieving state-of-the-art performance while minimizing development costs. \InfR~ aims to advance AI systems by improving reasoning, reducing adoption barriers, and addressing privacy concerns through smaller model sizes. Resources are available at https://github. com/Reallm-Labs/InfiR.

Multilingual Pre-trained Language models (multiPLMs), trained on the Masked Language Modelling (MLM) objective are commonly being used for cross-lingual tasks such as bitext mining. However, the performance of these models is still suboptimal for low-resource languages (LRLs). To improve the language representation of a given multiPLM, it is possible to further pre-train it. This is known as continual pre-training. Previous research has shown that continual pre-training with MLM and subsequently with Translation Language Modelling (TLM) improves the cross-lingual representation of multiPLMs. However, during masking, both MLM and TLM give equal weight to all tokens in the input sequence, irrespective of the linguistic properties of the tokens. In this paper, we introduce a novel masking strategy, Linguistic Entity Masking (LEM) to be used in the continual pre-training step to further improve the cross-lingual representations of existing multiPLMs. In contrast to MLM and TLM, LEM limits masking to the linguistic entity types nouns, verbs and named entities, which hold a higher prominence in a sentence. Secondly, we limit masking to a single token within the linguistic entity span thus keeping more context, whereas, in MLM and TLM, tokens are masked randomly. We evaluate the effectiveness of LEM using three downstream tasks, namely bitext mining, parallel data curation and code-mixed sentiment analysis using three low-resource language pairs English-Sinhala, English-Tamil, and Sinhala-Tamil. Experiment results show that continually pre-training a multiPLM with LEM outperforms a multiPLM continually pre-trained with MLM+TLM for all three tasks.

Large language models have become a potential pathway toward achieving artificial general intelligence. Recent works on multi-modal large language models have demonstrated their effectiveness in handling visual modalities. In this work, we extend the research of MLLMs to point clouds and present the LAMM-Dataset and LAMM-Benchmark for 2D image and 3D point cloud understanding. We also establish an extensible framework to facilitate the extension of MLLMs to additional modalities. Our main contribution is three-fold: 1) We present the LAMM-Dataset and LAMM-Benchmark, which cover almost all high-level vision tasks for 2D and 3D vision. Extensive experiments validate the effectiveness of our dataset and benchmark. 2) We demonstrate the detailed methods of constructing instruction-tuning datasets and benchmarks for MLLMs, which will enable future research on MLLMs to scale up and extend to other domains, tasks, and modalities faster. 3) We provide a primary but potential MLLM training framework optimized for modalities' extension. We also provide baseline models, comprehensive experimental observations, and analysis to accelerate future research. Codes and datasets are now available at https://github.com/OpenLAMM/LAMM.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

Multimodal large language models (MLLMs) have recently achieved impressive general-purpose vision-language capabilities through visual instruction tuning. However, current MLLMs primarily focus on image-level or box-level understanding, falling short of achieving fine-grained vision-language alignment at the pixel level. Besides, the lack of mask-based instruction data limits their advancements. In this paper, we propose Osprey, a mask-text instruction tuning approach, to extend MLLMs by incorporating fine-grained mask regions into language instruction, aiming at achieving pixel-wise visual understanding. To achieve this goal, we first meticulously curate a mask-based region-text dataset with 724K samples, and then design a vision-language model by injecting pixel-level representation into LLM. Especially, Osprey adopts a convolutional CLIP backbone as the vision encoder and employs a mask-aware visual extractor to extract precise visual mask features from high resolution input. Experimental results demonstrate Osprey's superiority in various region understanding tasks, showcasing its new capability for pixel-level instruction tuning. In particular, Osprey can be integrated with Segment Anything Model (SAM) seamlessly to obtain multi-granularity semantics. The source code, dataset and demo can be found at https://github.com/CircleRadon/Osprey.

Although recent advances in scaling large language models (LLMs) have resulted in improvements on many NLP tasks, it remains unclear whether these models trained primarily with general web text are the right tool in highly specialized, safety critical domains such as clinical text. Recent results have suggested that LLMs encode a surprising amount of medical knowledge. This raises an important question regarding the utility of smaller domain-specific language models. With the success of general-domain LLMs, is there still a need for specialized clinical models? To investigate this question, we conduct an extensive empirical analysis of 12 language models, ranging from 220M to 175B parameters, measuring their performance on 3 different clinical tasks that test their ability to parse and reason over electronic health records. As part of our experiments, we train T5-Base and T5-Large models from scratch on clinical notes from MIMIC III and IV to directly investigate the efficiency of clinical tokens. We show that relatively small specialized clinical models substantially outperform all in-context learning approaches, even when finetuned on limited annotated data. Further, we find that pretraining on clinical tokens allows for smaller, more parameter-efficient models that either match or outperform much larger language models trained on general text. We release the code and the models used under the PhysioNet Credentialed Health Data license and data use agreement.